Individual
JAN HOWE WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 MOYE BLVD, ECU PHYSICIANS AT LEO W. JENKINS CANCER SERVICES, GREENVILLE, NC 27834-4300
(252) 744-1888
(252) 744-7005
Mailing address
P.O. BOX 751069, ECU PHYSICAINS, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
2010-01582
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00533401
—
HI
01
—
1590C
BCBSNC
NC
05
—
5915789
—
NC
Enumeration date
09/16/2006
Last updated
12/07/2011
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