Individual
DOMINGO T HONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1990 WISCONSIN AVE, GRAFTON, WI 53024-2601
(262) 375-2305
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(262) 375-2305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18307
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31157500
—
WI
Enumeration date
07/17/2006
Last updated
05/25/2011
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