Look up the most recent NPI and PECOS records

Kenneth C. Wang

Radiology

Allopathic & Osteopathic Physicians

600 N Wolfe St, Dept. Radiology, Blalock 100, Baltimore, MD 21287-0005

PECOS Enrollment

This provider is enrolled in PECOS as KENNETH WANG.

Based on the most recent information from CMS, provider Kenneth C. Wang is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1750428173
Provider Type
Individual
Full Name
Wang, Kenneth C.
Title
Dr.
Credential
MD, PHD

Gender
Male
Sole Proprietor
No
Enumeration Date
2/1/2007
Last Updated
8/5/2009

Contact Information

Practice Location

600 N Wolfe St, Dept. Radiology, Blalock 100, Baltimore, MD 21287-0005

(410) 955-6500

(443) 287-3622

Mailing Location

600 N Wolfe St, Dept. Radiology, Blalock 100, Baltimore, MD 21287-0005

(410) 955-6500

(443) 287-3622

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License D0065047 Maryland

Provider Identifiers

ID	Description	Issuer
ID 022617300	Description Medicaid	Issuer Unlisted Maryland

Kenneth C. Wang

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Lazarow, Frances Barbara

Desai, Neal

Campbell, Laura Kathryn

Pacheco-Luna, Licia

Liu, Gigi

Feigin, David Simon

Doshi, Neha Hirendra

Lawler, Leo

Tan, Christopher Michael

Ambinder, Emily Bayle Mcintosh