| Paul H Wang M Div Ph D & Associates P C | |
|
9666 Olive Blvd Ste 510 Saint Louis MO 63132-3026 | |
| (314) 721-7777 | |
| (314) 888-2610 |
| Full Name | Paul H Wang M Div Ph D & Associates P C |
|---|---|
| Speciality | Psychologist |
| Location | 9666 Olive Blvd Ste 510, Saint Louis, Missouri |
| Authorized Official Name and Position | Paul H. Wang (PRESIDENT) |
| Authorized Official Contact | 3147217777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul H Wang M Div Ph D & Associates P C 9666 Olive Blvd Ste 510 Saint Louis MO 63132-3026 Ph: (314) 721-7777 | Paul H Wang M Div Ph D & Associates P C 9666 Olive Blvd Ste 510 Saint Louis MO 63132-3026 Ph: (314) 721-7777 |
| NPI Number | 1952684995 |
|---|---|
| Provider Enumeration Date | 09/26/2011 |
| Last Update Date | 08/21/2024 |
| Certification Date | 08/21/2024 |
| Medicare PECOS PAC ID | 9739351370 |
|---|---|
| Medicare Enrollment ID | O20111004000498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952684995 | NPI | - | NPPES |
| 498172006 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY R0220 (Missouri) | Primary |
| Provider Name | Paul H Wang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396769295 PECOS PAC ID: 4789633132 Enrollment ID: I20050217000114 |
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