Provider Demographics
NPI:1699056408
Name:FONG, HENRY HUNG CHONG (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:HUNG CHONG
Last Name:FONG
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 1:1915 ALEWA DR.
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1215
Mailing Address - Country:US
Mailing Address - Phone:808-595-3573
Mailing Address - Fax:
Practice Address - Street 1:1915 ALEWA DR.
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1215
Practice Address - Country:US
Practice Address - Phone:808-595-3573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI965207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine