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General NPI Number Information
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NPI Number | 1174815997
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Entity Type | Individual
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Provider Name | XIXI WONG M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2011
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 20 CEDAR BLVD STE 410
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City | PITTSBURGH
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State | PA
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Zip | 15228
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Country | US
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Telephone | 901-830-0820
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Fax |
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Provider Business Mailing Address
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Address Line | 3206 WILLOW RIDGE DR
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City | BRIDGEVILLE
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State | PA
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Zip | 15017-1597
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Country | US
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Telephone | 901-830-0820
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MT198896
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MT198896
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD450948
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License Number State | PA
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