Provider Demographics
NPI:1003817586
Name:ONG, ADRIAN W (MD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:W
Last Name:ONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ADRIAN
Other - Middle Name:WEI-HUAN
Other - Last Name:ONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3400 SPRUCE STREET
Mailing Address - Street 2:2 DULLES
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:215-662-7320
Mailing Address - Fax:412-359-8639
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:2 DULLES
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-662-7320
Practice Address - Fax:412-359-8639
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4188602086S0102X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2337546Medicaid
WV3004235000Medicaid
PA0019001760001Medicaid
PAH64598Medicare UPIN
PA0019001760001Medicaid
PA059122NJ8Medicare PIN