Provider Demographics
NPI:1609100577
Name:WONG, CHONG HUEY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHONG
Middle Name:HUEY
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 1:11800 EDGEWATER DR APT 415
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1750
Mailing Address - Country:US
Mailing Address - Phone:216-849-9221
Mailing Address - Fax:
Practice Address - Street 1:11800 EDGEWATER DR APT 415
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-1750
Practice Address - Country:US
Practice Address - Phone:216-849-9221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program