Provider Demographics
NPI:1508859083
Name:WONG, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7800 E ORCHARD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2583
Mailing Address - Country:US
Mailing Address - Phone:303-697-7463
Mailing Address - Fax:303-783-1200
Practice Address - Street 1:7800 E ORCHARD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2583
Practice Address - Country:US
Practice Address - Phone:303-697-7463
Practice Address - Fax:303-783-1200
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2012-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO25970207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01259704Medicaid
COP0076170OtherMEDICARE RAILROAD
COP0076170OtherMEDICARE RAILROAD