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Individual
MICHAEL WALTER WONG
Active
Individual
MICHAEL WALTER WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS020084
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
OS020084
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-2650420
—
PA
Enumeration date
05/18/2015
Last updated
02/08/2023
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