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Individual

DR. WALTER KHE TIAN WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2424 S 90TH ST, SUITE 202, WEST ALLIS, WI 53227-2455
(414) 328-7646
(414) 328-7699
Mailing address
2424 S 90TH ST, SUITE 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
09/13/2005
Last updated
09/15/2009
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