| Russell Wong Md Inc | |
|
321 N Kuakini St Ste 811 Honolulu HI 96817-2362 | |
| (808) 531-2731 | |
| Not Available |
| Full Name | Russell Wong Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 321 N Kuakini St Ste 811, Honolulu, Hawaii |
| Authorized Official Name and Position | Russell Wong (PRESIDENT) |
| Authorized Official Contact | 8085312731 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Wong Md Inc Po Box 25370 Honolulu HI 96825-0370 Ph: (808) 536-0300 | Russell Wong Md Inc 321 N Kuakini St Ste 811 Honolulu HI 96817-2362 Ph: (808) 531-2731 |
| NPI Number | 1780693267 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 10/24/2007 |
| Medicare PECOS PAC ID | 7810888088 |
|---|---|
| Medicare Enrollment ID | O20040324001537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780693267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 7430 (Hawaii) | Primary |
| Provider Name | Russell Wong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376573808 PECOS PAC ID: 1153212329 Enrollment ID: I20060104000603 |
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