Provider Demographics
NPI:1295771954
Name:WONG, HON YUEN (MD)
Entity type:Individual
Prefix:DR
First Name:HON YUEN
Middle Name:
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 1:751 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE 13A
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1142
Mailing Address - Country:US
Mailing Address - Phone:301-738-6880
Mailing Address - Fax:301-251-5675
Practice Address - Street 1:751 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 13A
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1142
Practice Address - Country:US
Practice Address - Phone:301-738-6880
Practice Address - Fax:301-251-5675
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035836L207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0170917OtherBLUE CROSS
PA1017946010002Medicaid
PA751893OtherBLUE CROSS
PA1007582710009Medicaid
PA87628OtherUNISON
MDKG16DROtherBLUE CROSS
PA1504515OtherGATEWAY
PA1007582710009Medicaid
PA1504515OtherGATEWAY
PA751893OtherBLUE CROSS