Provider Demographics
NPI:1811082563
Name:WEI, FONG (MD)
Entity type:Individual
Prefix:
First Name:FONG
Middle Name:
Last Name:WEI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:419 N HARRISON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3521
Mailing Address - Country:US
Mailing Address - Phone:609-924-9300
Mailing Address - Fax:609-430-9481
Practice Address - Street 1:419 N HARRISON ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3521
Practice Address - Country:US
Practice Address - Phone:609-924-9300
Practice Address - Fax:609-430-9481
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02912700207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0089569000OtherAMERIHLTH/IBC SPECIALTY
MES084OtherOXFORD SPECIALTY
NJ1811290OtherUNITED HEALTH CARE
NJ0690309Medicaid
110137124OtherRAILROAD MED.-PRINCETON
2186502OtherAETNA SPECIALTY
877482OtherAETNA PCP
MEP074OtherOXFORD PCP
110137135OtherRAILROAD MED- MONROE
176359OtherAMERIHLTH ADMIN SPECIALTY
NJ0690309Medicaid
MEP074OtherOXFORD PCP