Individual
RUSSELL HOW KEONG WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 14TH ST SW, LARGO, FL 33770-3133
(727) 588-5812
(727) 588-5911
Mailing address
PO BOX 741087, ATLANTA, GA 30374-1087
(727) 588-5812
(727) 588-5911
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
ME87050
FL
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
ME87050
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME87050
FL
Other
Enumeration date
11/22/2006
Last updated
03/23/2020
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