Individual
IAN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
924 FAYETTE ST, INDIANAPOLIS, IN 46202-3019
(317) 687-9664
Mailing address
924 FAYETTE ST, INDIANAPOLIS, IN 46202-3019
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11012559A
IN
Other
Enumeration date
07/01/2008
Last updated
07/01/2008
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