Wong, Dominique M

Wong, Dominique M is an individual health care provider with primary practice located at 1340 Hal Greer Blvd , Huntington WV 25701-3804. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Wong, Dominique M can be contacted via phone (304) 526-2200.

Contact Information

Primary practice address
1340 Hal Greer Blvd Huntington WV 25701-3804
Fax: (304) 399-1507
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 19271 West Virginia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 19271 West Virginia

Profile Details

NPI number 1396715652
LBN Legal business name Wong, Dominique M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Apr 13th, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396715652 NPPES
Kentucky MEDICAID 7100102840
Kentucky MEDICAID 2972832
Kentucky MEDICAID 1396715652

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