Wong, Mary
Wong, Mary is an sole proprietor health care provider with primary practice located at 6780 Mayfield Rd , Mayfield Hts OH 44124-2203. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities is her primary health care specialty. Wong, Mary can be contacted via phone (216) 449-4500.Contact Information
Primary practice address
6780 Mayfield Rd
Mayfield Hts OH 44124-2203
Phone: (216) 449-4500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities | 2080P0008X | 35.078204 | Ohio |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35.078204 | Ohio |
Profile Details
| NPI number | 1417994195 |
|---|---|
| LBN Legal business name | Wong, Mary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2006 |
| Last updated | Mar 31st, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417994195 | NPPES |
| Ohio | Other | 942460636468 | CARESOURCE |
| Ohio | MEDICAID | 2216444 | CARESOURCE |
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