Provider Demographics
NPI:1194705012
Name:WONG, CHRISTOPHER J (DO)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:WONG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 820137
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0137
Mailing Address - Country:US
Mailing Address - Phone:610-270-2352
Mailing Address - Fax:610-270-2358
Practice Address - Street 1:559 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4250
Practice Address - Country:US
Practice Address - Phone:484-622-1244
Practice Address - Fax:484-622-1542
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012448207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2422968000OtherAMERIHEALTH/INTERCOUNTY
PAOS012448OtherHEALTH PARTNERS
PA101350418Medicaid
PA30025431OtherKEYSTONE MERCY
PA2422968000OtherIBC - PC, KHPE
PA1757866OtherHIGHMARK BLUE SHIELD
PA30025431OtherKEYSTONE MERCY
PA1757866OtherHIGHMARK BLUE SHIELD