Individual
DR. CHARLES CHU-LI WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1729 KINNEYS LANE, SUITE 203, PORTSMOUTH, OH 45662-3167
(740) 354-2942
(740) 353-3661
Mailing address
1729 KINNEYS LANE, SUITE 203, PORTSMOUTH, OH 45662-3167
(740) 354-2942
(704) 353-3661
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35063264W
OH
207RG0100X
Gastroenterology Physician
63264
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0879705
—
OH
Enumeration date
06/13/2005
Last updated
09/11/2019
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