Individual
DEEN L WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
79-1019 HAUKAPILA ST, KEALAKEKUA, HI 96750-7920
(808) 322-9366
(808) 324-1892
Mailing address
PO BOX 652, KEALAKEKUA, HI 96750-0652
(808) 322-9366
(808) 324-1892
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
MD4676
HI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD4676
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407901
—
HI
01
—
990280549
HMAA
HI
01
—
A14983
HMSA
HI
01
—
MD4676
QUEENS
HI
Enumeration date
11/01/2006
Last updated
03/24/2010
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