| Family Medicine & Weight Loss Md Pllc | |
|
420 S Germantown Pkwy Suite 105b Cordova TN 38018-4387 | |
| (901) 842-1473 | |
| Not Available |
| Full Name | Family Medicine & Weight Loss Md Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 420 S Germantown Pkwy, Cordova, Tennessee |
| Authorized Official Name and Position | Haiqiu E Wang (SOLE MEMBER) |
| Authorized Official Contact | 9018421473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine & Weight Loss Md Pllc 420 S Germantown Pkwy Suite 105b Cordova TN 38018-4387 Ph: (901) 842-1473 | Family Medicine & Weight Loss Md Pllc 420 S Germantown Pkwy Suite 105b Cordova TN 38018-4387 Ph: (901) 842-1473 |
| NPI Number | 1598176687 |
|---|---|
| Provider Enumeration Date | 05/12/2014 |
| Last Update Date | 05/13/2014 |
| Medicare PECOS PAC ID | 0749403723 |
|---|---|
| Medicare Enrollment ID | O20140520001114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598176687 | NPI | - | NPPES |
| 6012116 | Other | TN | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 37771 (Tennessee) | Primary |
| Provider Name | Haiqiu E Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467466136 PECOS PAC ID: 4981688736 Enrollment ID: I20040617000935 |
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