Walter J Wang, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

7346 Issued in HI

Practice address

74-5620 Palani Rd
Suite 100
Kailua-Kona, HI 96740

Phone

(808) 331-8860

Fax

(808) 334-1620

NPI assigned

Jun 12, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2013 through Oct 1, 2027

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1215197348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74-5620 PALANI RD",
            "address_2": "SUITE 100",
            "city": "KAILUA-KONA",
            "state": "HI",
            "postal_code": "96740",
            "telephone_number": "808-331-8860",
            "fax_number": "808-334-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74-5620 PALANI RD",
            "address_2": "SUITE 100",
            "city": "KAILUA-KONA",
            "state": "HI",
            "postal_code": "96740",
            "telephone_number": "808-331-8860",
            "fax_number": "808-334-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "WALTER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "7346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walmart, Inc.
• Tina Walter
• Allan Veh Tuc Wang, MD, PHD
• Sophia J Wang, PHD
• Theresa Ihsin Wang, M.D.
• Cristina Maria Ward
• Michael Warnecke, BSN, RN
• Mary Katherine Warren, M.D.
• Jamal Fulani Wasan, PH.D
• Michaela Watts, ND

• Family Medicine Physician in Kailua-Kona, HI
• Providers in Kailua-Kona, HI by specialty
• Family Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.

Verify at the official NPI Registry.