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General NPI Number Information
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NPI Number | 1700042686
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Entity Type | Organization
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Legal Business Name | NAOMI WIGS
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 6050 GORGAS RD BLDG2303
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City | FORT BELVOIR
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State | VA
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Zip | 22060
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Country | US
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Telephone | 703-360-5751
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Fax | 703-360-5751
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Provider Business Mailing Address
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Address Line | 6901 SECURITY BLVD UNIT 545
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City | BALTIMORE
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State | MD
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Zip | 21244
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Country | US
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Telephone | 410-277-0377
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Fax | 410-277-0377
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Authorized Official
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Title or Position | OWNER
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Name | SUNG H. HWANG
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Credential |
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Telephone | 703-360-5751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 332B00000X
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License Number State | VA
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