Emma C Wang, DO

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

002001493 Issued in IN

Practice address

3006 Lincolnway E
Mishawaka, IN 46544-3501

Phone

(574) 252-7133

Fax

(844) 361-2090

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1982647434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 LINCOLNWAY E",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465443501",
            "telephone_number": "574-252-7133",
            "fax_number": "844-361-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 LINCOLNWAY E",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465443501",
            "telephone_number": "574-252-7133",
            "fax_number": "844-361-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "EMMA",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001493",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "IN",
            "license": "002001493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300037230",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Joseph Walter, DO
• Janiyah Naysha-Nikkole Walton
• Lileann Jean Waltz
• Diane Marie Wandling, LCSW
• Arthur F Wang, MD
• Frank C Wang Jr., OD
• Jennifer Ward
• Charles McDonald Ware Jr., M.D.
• Jill N. Warfield-Ziegert, O.D.
• Jan Earl Warner, PHD HSPP

• Addiction Medicine (Family Medicine) Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Addiction Medicine (Family Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.