Provider Demographics
NPI:1871771808
Name:WANG, JEFFREY YE-CHANG (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:YE-CHANG
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:20410 OBSERVATION DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4000
Mailing Address - Country:US
Mailing Address - Phone:301-330-1000
Mailing Address - Fax:301-330-9108
Practice Address - Street 1:20410 OBSERVATION DR
Practice Address - Street 2:SUITE 100
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4000
Practice Address - Country:US
Practice Address - Phone:301-330-1000
Practice Address - Fax:301-330-9108
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0592292086S0129X
MDD00686162086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD056174600Medicaid
MD158423ZDDVMedicare PIN
MD056174600Medicaid