Individual
LAI WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-4422
(410) 328-0177
Mailing address
920 ELKRIDGE LANDING RD, LINTHICUM, MD 21090-2917
(443) 462-5010
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R165769
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
414872000
—
MD
Enumeration date
05/27/2008
Last updated
12/14/2016
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