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Individual

KEN KOON WONG

Active
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Individual

KEN KOON WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-125312
OH
207RI0200X
Infectious Disease Physician
Primary
35-125312
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0123634
OH
01
0454744
AKRON GENERAL (IMCA) MEDICAID GROUP #
OH
01
1821035940
AKRON GENERAL TYPE 2 NPI #
OH
01
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
3600271
AKRON GENERAL MEDICARE GROUP #
OH
Enumeration date
07/10/2010
Last updated
01/08/2016
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