Provider Demographics
NPI:1619364833
Name:WONG-OKAFOR, TAHNEE (MD)
Entity Type:Individual
Prefix:DR
First Name:TAHNEE
Middle Name:
Last Name:WONG-OKAFOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAHNEE
Other - Middle Name:
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1906 BELLEVIEW AVE SE
Mailing Address - Street 2:CARILION CLINIC ROANOKE MEMORIAL HOSPITAL
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1838
Mailing Address - Country:US
Mailing Address - Phone:540-981-7000
Mailing Address - Fax:
Practice Address - Street 1:1906 BELLEVIEW AVE SE
Practice Address - Street 2:CARILION CLINIC ROANOKE MEMORIAL HOSPITAL
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1838
Practice Address - Country:US
Practice Address - Phone:540-981-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-26
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA01160278002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program