Individual
DR. JAIME ALAN WAN CHEUNG WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
003186
NY
208800000X
Urology Physician
Primary
063232
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063232
GEORGIA STATE LICENSE
GA
Enumeration date
09/04/2008
Last updated
10/05/2011
Update your record
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