Individual
NANCY WANG FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7494
(216) 286-6341
Mailing address
3605 WARRENSVILLE CENTER RD, 1ST FL,MSC9152, SHAKER HTS, OH 44122-5203
(216) 286-6299
(216) 286-6341
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
35-069513
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000188079
ANTHEM
OH
01
—
000000224339
UNISON
OH
01
—
000000528781
ANTHEM
OH
01
—
0127464
BCMH
OH
01
—
1851324370
MI MEDICAID
OH
01
—
2068157
UHC
OH
01
—
220029791
RAILROAD MEDICARE
OH
05
—
2213250
—
OH
01
—
364110
WELLCARE
OH
01
—
743236
BUCKEYE
OH
01
—
7849101
AETNA
OH
01
—
P00454334
RAILROAD MEDICARE
OH
Enumeration date
07/08/2006
Last updated
05/21/2008
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