Individual
DR. DOMINIQUE M WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3804
(304) 526-2200
(304) 399-1507
Mailing address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3804
(304) 526-2200
(304) 399-1507
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19271
WV
207Q00000X
Family Medicine Physician
19271
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396715652
—
WV
05
—
2972832
—
OH
05
—
7100102840
—
KY
Enumeration date
01/26/2006
Last updated
04/13/2021
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