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Individual

DR. CHRISTINE JANEL HAYWOOD BONG

Active
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Individual

DR. CHRISTINE JANEL HAYWOOD BONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D., FAAP, M.P.H.

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
47375
CO
208000000X
Pediatrics Physician
LL28136
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
37336843
CO
01
47375
MEDICAL LICENSE
CO
01
CO306759
MEDICARE PTAN
CO
01
LL28136
LIMITED MEDICAL LICENSE
SC
Enumeration date
04/04/2007
Last updated
03/07/2023
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