Individual
TINA W WONG-GILLAM
Active
Individual
TINA W WONG-GILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.-PH.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301508285
MI
2086X0206X
Surgical Oncology Physician
Primary
4301508285
MI
Other
Enumeration date
04/30/2015
Last updated
05/09/2025
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