Provider Demographics
NPI:1174815997
Name:WONG, XIXI (MD)
Entity Type:Individual
Prefix:DR
First Name:XIXI
Middle Name:
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 WILLOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1597
Mailing Address - Country:US
Mailing Address - Phone:901-830-0820
Mailing Address - Fax:
Practice Address - Street 1:20 CEDAR BLVD STE 410
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228
Practice Address - Country:US
Practice Address - Phone:901-830-0820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT198896207Q00000X, 2084P0800X
PAMD4509482084P0800X
TN533642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine