Individual
KERI S. WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14044 W CAMELBACK RD, SUITE 118, LITCHFIELD PARK, AZ 85340-9428
(623) 547-2600
(623) 547-1899
Mailing address
14044 W CAMELBACK RD, SUITE 118, LITCHFIELD PARK, AZ 85340-9428
(623) 547-2600
(623) 547-1899
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
48640
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01197934
RR MEDICARE
MN
Enumeration date
10/15/2008
Last updated
06/09/2015
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