Individual
GARY XIN GONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287
(410) 955-6500
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
056776
CT
2085R0202X
Diagnostic Radiology Physician
Primary
D61497
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4048407000
—
MD
Enumeration date
05/17/2006
Last updated
09/05/2024
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