Provider Demographics
NPI:1790868826
Name:HON W FONG DPM PLLC
Entity Type:Organization
Organization Name:HON W FONG DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HON
Authorized Official - Middle Name:W
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:734-716-6434
Mailing Address - Street 1:PO BOX 87949
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-0949
Mailing Address - Country:US
Mailing Address - Phone:734-716-6434
Mailing Address - Fax:
Practice Address - Street 1:2050 N HAGGERTY RD STE 120
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3796
Practice Address - Country:US
Practice Address - Phone:734-981-1086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHF002084213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty