Provider Demographics
NPI:1861725343
Name:WONG, PAUL (RN)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:WONG
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NIH CLINICAL CTR
Mailing Address - Street 2:10 CENTER DR. RM 5-5441
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:240-496-6742
Mailing Address - Fax:
Practice Address - Street 1:NIH CLINICAL CTR
Practice Address - Street 2:10 CENTER DR. RM 5-5441
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:240-496-6742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR210158163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine