Organization
126TH STREET MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR GONG MD (MEDICAL OFFICER)
(410) 250-8000
Entity
Organization
Contact information
Practice address
12601 D COASTAL HIGHWAY, OCEAN CITY, MD 21842-9784
(410) 250-8000
(410) 250-1308
Mailing address
12601 D COASTAL HIGHWAY, OCEAN CITY, MD 21842-9784
(410) 250-8000
(410) 250-1308
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0032615
MD
Other
Enumeration date
08/15/2005
Last updated
08/22/2020
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