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Organization

75TH STREET MEDICAL PA

Active
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Organization

75TH STREET MEDICAL PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VICTOR GONG M.D. (MEDICAL DIRECTOR)
(410) 524-0075
Entity
Organization

Contact information

Practice address
7408 COASTAL HWY, OCEAN CITY, MD 21842-2936
(410) 524-0075
(410) 524-0066
Mailing address
7408 COASTAL HWY, OCEAN CITY, MD 21842-2936
(410) 524-0075
(410) 524-0066

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0032615
MD

Other

Enumeration date
08/03/2005
Last updated
11/04/2008
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