| Doctor Name: | DR. PETER S WANG |
| NPI Number: | 1114128204 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD442315 |
| Business Practice Address: | 5501 Old York Rd Philadelphia, PA - 191413018 |
| Business Phone Number: | 2154567890 |
| Business Fax Number: | |
| Mailing Address: | 101 E Olney Ave, Suite 400 PHILADELPHIA |
| State: | PA |
| Postal Code: | 191202421 |
| Phone Number: | 2154567000 |
| Fax Number: | |
| NPI Enumeration Date: | 05/29/2007 |
| NPI Last Update Date: | 06/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | MD442315 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |