Organization
75TH STREET MEDICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR GONG M.D. (MEDICAL DIRECTOR)
(410) 524-0075
Entity
Organization
Contact information
Practice address
7408 COASTAL HWY, OCEAN CITY, MD 21842-2936
(410) 524-0075
(410) 524-0066
Mailing address
7408 COASTAL HWY, OCEAN CITY, MD 21842-2936
(410) 524-0075
(410) 524-0066
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0032615
MD
Other
Enumeration date
08/03/2005
Last updated
11/04/2008
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