Individual
DR. BERT Y.S. WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 E BOULDER ST, SUITE # 700, COLORADO SPRINGS, CO 80909-5533
(719) 635-7173
(719) 636-9225
Mailing address
40 BERTHE CIR, COLORADO SPRINGS, CO 80906-3162
(719) 635-7172
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25298
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01252980
—
CO
Enumeration date
07/18/2005
Last updated
11/28/2007
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