Individual
ALVIN GIBSON WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 W MICHIGAN ST # CL626, INDIANAPOLIS, IN 46202-5209
(317) 278-2686
(317) 278-2650
Mailing address
1120 W MICHIGAN ST # CL626, INDIANAPOLIS, IN 46202-5209
(317) 278-2686
(317) 278-2650
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11018732A
IN
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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