Individual
EDITH WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 E ROSSER AVE., BISMARCK, ND 58501-4461
(701) 751-9500
(701) 751-9508
Mailing address
701 E ROSSER AVE., BISMARCK, ND 58501-4461
(701) 751-9500
(701) 751-9508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RL13778
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12083
—
ND
Enumeration date
07/24/2015
Last updated
07/24/2015
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