Active NPI
Peter Wang, M.D.
- Internal Medicine Physician
- Detroit, MI
National Provider Identifier
1699020628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301101479
- Practice address
- 6071 W Outer Dr
Detroit, MI 48235-2624 - Phone
- (313) 966-3250
- Fax
- (313) 966-1738
- NPI assigned
- Jul 16, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301101479 | MI | Primary |
Addresses
Primary practice location
6071 W Outer Dr
Detroit, MI 48235-2624
Mailing address
6071 W Outer Dr
Detroit, MI 48235-2624
Phone (313) 966-3250
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 |
|---|---|---|---|
| 4301101479 | MI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342396800000",
"number": "1699020628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6071 W OUTER DR",
"city": "DETROIT",
"state": "MI",
"postal_code": "482352624",
"telephone_number": "313-966-3250",
"fax_number": "313-966-1738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6071 W OUTER DR",
"city": "DETROIT",
"state": "MI",
"postal_code": "482352624",
"telephone_number": "313-966-3250",
"fax_number": "313-966-1738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "PETER",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-16",
"last_updated": "2012-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301101479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.