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Individual

HON WA FONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2050 N HAGGERTY RD, SUITE 120, CANTON, MI 48187-3795
(734) 981-1086
(734) 981-2259
Mailing address
PO BOX 87949, CANTON, MI 48187-0949
(734) 716-6434

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
5904002084
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002084
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4748127
MI
01
480D710100
HWL BC GROUP
MI
01
4858213520
INDIVIDUAL BC
MI
Enumeration date
02/10/2006
Last updated
06/18/2008
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