Provider Demographics
NPI:1730747601
Name:WANG, LINDA FAN (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:FAN
Last Name:WANG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LOTHROP ST
Mailing Address - Street 2:M2, C-WING
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:412-647-8666
Mailing Address - Fax:412-647-7080
Practice Address - Street 1:200 LOTHROP STREET
Practice Address - Street 2:M2, C-WING
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-647-8666
Practice Address - Fax:412-647-7080
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA280485390200000X
PAMT225086207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program