Provider Demographics
NPI:1649479585
Name:WONG, TIMOTHY CHUNG-TIN (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:CHUNG-TIN
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 1:200 LOTHROP ST
Mailing Address - Street 2:SCAIFE HALL S-569
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-648-9286
Mailing Address - Fax:412-648-5991
Practice Address - Street 1:300 HALKET ST
Practice Address - Street 2:SUITE 5102
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3108
Practice Address - Country:US
Practice Address - Phone:412-641-8870
Practice Address - Fax:412-641-8880
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD437113207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102314640Medicaid
PA102314640Medicaid