Individual
CARSON WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 MATTHEW ST STE 303, MARIETTA, OH 45750-1656
(740) 373-7828
(740) 373-5898
Mailing address
6900 PEARL RD, SECOND FLOOR, MIDDLEBURG HEIGHTS, OH 44130-3639
(440) 845-0900
(440) 842-9911
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
23694
OK
208800000X
Urology Physician
Primary
35052657
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3154616
—
OH
Enumeration date
03/12/2006
Last updated
07/15/2021
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