Active NPI
Charles H. Wang, MD
- Anatomic Pathology & Clinical Pathology Physician
- Salt Lake City, UT
National Provider Identifier
1689316804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 13509666-1205
- Practice address
- Eccles Insititute of Human Genetics: 15 N Medical Dr.
Salt Lake City, UT 84112-1100 - Phone
- (801) 581-2121
- NPI assigned
- Apr 8, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 13509666-1205 | UT | Primary |
Addresses
Primary practice location
Eccles Insititute of Human Genetics: 15 N Medical Dr.
Salt Lake City, UT 84112-1100
Mailing address
Eccles Insititute of Human Genetics: 15 N Medical Dr.
Salt Lake City, UT 84112-1100
Phone (801) 581-2121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13509666-1205 | UT | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691625600000",
"number": "1689316804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ECCLES INSITITUTE OF HUMAN GENETICS: 15 N MEDICAL DR.",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841121100",
"telephone_number": "801-581-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ECCLES INSITITUTE OF HUMAN GENETICS: 15 N MEDICAL DR.",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841121100",
"telephone_number": "801-581-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "CHARLES",
"middle_name": "H.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-08",
"last_updated": "2023-08-10",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "UT",
"license": "13509666-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.