Individual
NATHAN A WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
94-1480 MOANIANI ST, WAIPAHU, HI 96797-4632
(808) 432-3100
Mailing address
94-1480 MOANIANI ST, WAIPAHU, HI 96797-4632
(808) 432-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-2899
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040919-02
—
HI
Enumeration date
01/25/2007
Last updated
10/19/2007
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