Organization
WALTER K T WONG MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER K. T. WONG MD (OWNER)
(414) 328-7646
Entity
Organization
Contact information
Practice address
2424 S 90TH ST, STE. 202, WEST ALLIS, WI 53227-2455
(414) 328-7646
(414) 328-7699
Mailing address
2424 S 90TH ST, STE. 202, WEST ALLIS, WI 53227-2455
(414) 328-7646
(414) 328-7699
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
24079
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30632800
—
WI
Enumeration date
01/05/2010
Last updated
01/20/2015
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