Individual
MISS WYKI GINA PANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22 BRAMHALL ST, DEPARTMENT OF MEDICINE, PORTLAND, ME 04102-3134
(207) 662-0111
Mailing address
22 BRAMHALL ST, DEPARTMENT OF MEDICINE, PORTLAND, ME 04102-3134
(207) 662-0111
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
25MA10390400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/21/2014
Last updated
04/17/2020
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