Provider Demographics
NPI:1023254273
Name:WANG, CHIA-CHI (DO)
Entity type:Individual
Prefix:
First Name:CHIA-CHI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ALUMNI DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2118
Mailing Address - Country:US
Mailing Address - Phone:603-775-7405
Mailing Address - Fax:603-775-7424
Practice Address - Street 1:3 ALUMNI DR STE 301
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2123
Practice Address - Country:US
Practice Address - Phone:603-775-7405
Practice Address - Fax:603-775-7424
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2531562086X0206X
DEC2-00098492086X0206X
CT0557252086X0206X
NH34736208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03112190Medicaid
NY03112190Medicaid