Individual
BRYAN Y WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
2946 E BANNER GATEWAY DR, GILBERT, AZ 85234
(480) 256-6444
(480) 256-4607
Mailing address
2940 E BANNER GATEWAY DR, SUITE 450, GILBERT, AZ 85234-2168
(480) 265-6444
(480) 265-4607
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
11456
NV
207RH0003X
Hematology & Oncology Physician
41477
AZ
207RX0202X
Medical Oncology Physician
Primary
41477
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
406300
—
AZ
01
—
P00732871
RAILROAD MEDICARE
AZ
Enumeration date
08/10/2005
Last updated
01/09/2012
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