Individual
STEPHEN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-6617
(215) 707-1684
Mailing address
2450 W HUNTING PARK AVE, 3RD FLOOR, PHILADELPHIA, PA 19129-1302
(215) 707-4739
(215) 707-3677
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD018519E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006793620001
—
PA
Enumeration date
10/12/2005
Last updated
04/09/2010
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