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Individual

DR. AMANDA L. KONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9200 W WISCONSIN AVE, SURGICAL ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5020
(414) 805-5771
Mailing address
9200 W WISCONSIN AVE, SURGICAL ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5020
(414) 805-5771

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
51977
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1063677755
WI
Enumeration date
07/23/2008
Last updated
01/18/2012
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