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Individual

STELLA C WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
531 ASBURY CIRCLE, STE N340, ATLANTA, GA 30322
(404) 778-5924
(404) 778-2630
Mailing address
222 14TH STREET NE, APT 532, ATLANTA, GA 30309
(404) 778-5924
(404) 778-2630

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
062454
GA
207P00000X
Emergency Medicine Physician
OS012850
PA
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
Primary
062454
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OS012850
STATE LICENSE
PA
Enumeration date
10/23/2006
Last updated
03/07/2023
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