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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 9 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 1417994195 NPPES
Ohio Other 942460636468 CARESOURCE
Ohio MEDICAID 2216444 CARESOURCE

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