Individual
DR. TIFFANY CLAIR FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1830 E MONUMENT ST, SUITE 6-100, BALTIMORE, MD 21287-0001
(410) 955-5107
(410) 502-5146
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-2704
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D76997
MD
207P00000X
Emergency Medicine Physician
MD445718
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528233855
NPI
PA
Enumeration date
04/28/2008
Last updated
01/12/2024
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