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General NPI Number Information
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NPI Number | 1609338524
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Entity Type | Individual
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Provider Name | FONG TOYED XIONG
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Gender | Male
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 2007 N BELFAST AVE
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City | AUGUSTA
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State | ME
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Zip | 04330-4363
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Country | US
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Telephone | 207-622-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 243 BRIDGE ST APT 2
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City | WESTBROOK
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State | ME
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Zip | 04092-3028
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Country | US
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Telephone | 209-556-7950
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PR68961
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License Number State | ME
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