Individual
EDGAR WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
32-36 CENTRAL AVE, WELLSBORO, PA 16901-1840
(570) 723-0140
(570) 724-6541
Mailing address
32-36 CENTRAL AVE, WELLSBORO, PA 16901-1840
(570) 723-0140
(570) 724-6541
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD030098E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010072670002
—
PA
05
—
2173426
—
NY
01
—
WO435288
BLUE CROSS/BLUE SHIELD
PA
Enumeration date
08/03/2006
Last updated
07/08/2007
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