Provider Demographics
NPI:1497890354
Name:WING, JOHN M (MD, MPH&TM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:WING
Suffix:
Gender:M
Credentials:MD, MPH&TM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 469
Mailing Address - Street 2:
Mailing Address - City:ANNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17003-9206
Mailing Address - Country:US
Mailing Address - Phone:717-865-8020
Mailing Address - Fax:
Practice Address - Street 1:EAATS-M
Practice Address - Street 2:CARE OF DMVA
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-5004
Practice Address - Country:US
Practice Address - Phone:717-861-9175
Practice Address - Fax:717-861-8235
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010442962083A0100X
PAMD4290162083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine