Individual
DR. GEORGE P ONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 WALNUT BOTTOM ROAD, BELVEDERE MEDICAL CORPORATION, CARLISLE, PA 17013-3698
(717) 245-0272
(717) 243-2357
Mailing address
850 WALNUT BOTTOM ROAD, BELVEDERE MEDICAL CORPORATION, CARLISLE, PA 17013-3698
(717) 245-0272
(717) 243-2357
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD022482E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008327500001
—
PA
01
—
183204
HIGHMARK BLUE SHIELD
—
01
—
50000625
CAP BLUE CROSS
—
Enumeration date
12/16/2005
Last updated
10/30/2007
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