Organization
T JOE WONGANANDA DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAAN JOE WONGANANDA DPM (DIRECTOR)
(443) 926-9147
Entity
Organization
Contact information
Practice address
806 LANDMARK DR, STE 128 - 129, GLEN BURNIE, MD 21061-4966
(443) 926-9147
(443) 926-9151
Mailing address
806 LANDMARK DR, STE 128 - 129, GLEN BURNIE, MD 21061-4966
(443) 926-9147
(443) 926-9151
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
01281
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166603700
—
MD
01
—
1982786844
MY INDIVIDUAL NPI
MD
Enumeration date
06/04/2007
Last updated
05/05/2011
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