MEDICARE: VIRGINIA L WONG MD

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	2086S0129X	Vascular Surgery Physician	35-081035	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00372970	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000221416	OTHER	OH	UNISON
4	745379	OTHER	OH	BUCKEYE

General Provider Information

NPI Number	:	1881612901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA L WONG MD

Provider Business Mailing Address
First Line	:	24701 EUCLID AVE
Second Line	:	THIRD FLOOR BILLING SERVICES
City	:	EUCLID
State	:	OH
Zip	:	44117-1714
Country	:	US
Telephone Number	:	440-585-7035
Fax Number	:	440-585-7032

Provider Business Practice Location Address
First Line	:	27100 CHARDON RD
Second Line	:	HARRINGTON HEART & VASCULAR INST
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-1116
Country	:	US
Telephone Number	:	440-585-7035
Fax Number	:	440-585-7032

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	12/30/2020

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Directions to “ VIRGINIA L WONG MD” Practice Location

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