Albert Kintim Wong, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D0025635 Issued in MD

Practice address

5500 Knoll North Dr Ste 490
Columbia, MD 21045-2380

Phone

(410) 964-1200

Fax

(410) 964-1002

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Kintim Albert Wong Other name

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1942279518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 490",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452380",
            "telephone_number": "410-964-1200",
            "fax_number": "410-964-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 490",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452380",
            "telephone_number": "410-964-1200",
            "fax_number": "410-964-1002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1406 Crain Hwy S",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210614058",
            "country_code": "US",
            "telephone_number": "410-787-2111",
            "fax_number": "410-787-7307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "ALBERT",
        "middle_name": "KINTIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "MD",
            "license": "D0025635",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0025635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301231000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KINTIM",
            "last_name": "WONG",
            "middle_name": "ALBERT",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kamryn Hailey Wolford
• Dana Elliott Wollney, M.D.
• Womankind OB/GYN Associates
• Women'S Health PT of Central MD LLC
• Diane Daeun Won
• Charity Wong
• Prudence Wong
• Francine Woniewala
• Amy Elizabeth Wood, PHARMD
• Charlotte Wood, LMSW

• Dermatology Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.