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1194705012

NPI Code Detail

MEDICARE: CHRISTOPHER J WONG D.O.

MEDICARE: CHRISTOPHER J WONG D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	OS012448	PA
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	OS012448	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2422968000	OTHER	PA	AMERIHEALTH/INTERCOUNTY
2	OS012448	OTHER	PA	HEALTH PARTNERS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	30025431	OTHER	PA	KEYSTONE MERCY
5	2422968000	OTHER	PA	IBC - PC, KHPE
6	1757866	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1194705012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER J WONG D.O.

Provider Business Mailing Address
First Line	:	PO BOX 820137
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19182-0137
Country	:	US
Telephone Number	:	610-270-2352
Fax Number	:	610-270-2358

Provider Business Practice Location Address
First Line	:	559 W GERMANTOWN PIKE
Second Line	:
City	:	EAST NORRITON
State	:	PA
Zip	:	19403-4250
Country	:	US
Telephone Number	:	484-622-1244
Fax Number	:	484-622-1542

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	10/15/2012

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Directions to “ CHRISTOPHER J WONG D.O.” Practice Location

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