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Individual

ANDREW M WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3334 CAPITAL MEDICAL BLVD STE 400, TALLAHASSEE, FL 32308-4470
(850) 877-8174
(850) 877-5636
Mailing address
3334 CAPITAL MEDICAL BLVD STE 400, TALLAHASSEE, FL 32308-4470
(850) 877-8174
(850) 877-5636

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
050854
GA
207X00000X
Orthopaedic Surgery Physician
ME59819
FL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
050854
GA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
ME59819
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000932302A
GA
05
000932302B
GA
05
378584000
FL
Enumeration date
05/24/2005
Last updated
11/23/2021
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