Provider Demographics
NPI:1447679436
Name:WANG, MIAOYUAN MAY (MD)
Entity type:Individual
Prefix:DR
First Name:MIAOYUAN
Middle Name:MAY
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1101 BEACON ST # 1E
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5587
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1101 BEACON ST STE 1E
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5587
Practice Address - Country:US
Practice Address - Phone:617-731-2390
Practice Address - Fax:617-731-1283
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAFW8336287207N00000X
MA278052207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery