Individual
EDWARD RAYMOND WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 WALL ST, INTERNAL MEDICINE, BURLINGTON, MA 01803-4758
(781) 221-2800
(781) 221-2680
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52950
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015268
NEIGHBORHOOD HEALTH
MA
01
—
052950
TUFTS
MA
05
—
3014347
—
MA
01
—
J06157
BLUE CROSS
MA
01
—
V303
HARVARD PILGRIM
MA
Enumeration date
05/05/2006
Last updated
05/16/2011
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