Provider Demographics
NPI:1891887725
Name:WONG, JOHN B (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:800 WASHINGTON ST
Mailing Address - Street 2:TUFTS MEDICAL CENTER 836
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1552
Mailing Address - Country:US
Mailing Address - Phone:617-636-7105
Mailing Address - Fax:617-636-6204
Practice Address - Street 1:800 WASHINGTON ST # 235
Practice Address - Street 2:TUFTS MEDICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1552
Practice Address - Country:US
Practice Address - Phone:617-636-1545
Practice Address - Fax:617-636-9712
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2010-07-20
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Provider Licenses
StateLicense IDTaxonomies
MA53939207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine