Organization
CAPITAL CENTER FOR FUNCTIONAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW WONG MD (FOUNDER AND MEDICAL DIRECTOR)
(301) 892-2658
Entity
Organization
Contact information
Practice address
4701 SANGAMORE RD STE N270, BETHESDA, MD 20816-2528
(240) 507-5110
Mailing address
416 GREEN PASTURE DR, ROCKVILLE, MD 20852-4233
(301) 892-2658
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D66066
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014051100
—
MD
Enumeration date
01/07/2015
Last updated
12/06/2024
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