Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301090894 | MI |
N | 111NI0900X | Internist | 4301090894 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | 4301090894 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | MD00043721 | WA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 35134077 | OH |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 4301090894 | MI |
NPI | 1023129426 |
---|---|
Provider Name | Wai Shun Wong |
First Address | Cincinnati, OH 45211-1106 |
Second Address | Cincinnati, OH 45211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 16/07/2018 |