Provider Demographics
NPI:1497375612
Name:WONG, ALFRED KA-SHING (MD)
Entity type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:KA-SHING
Last Name:WONG
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 1:2720 METROPOLITAN PKWY SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-7914
Mailing Address - Country:US
Mailing Address - Phone:404-905-9200
Mailing Address - Fax:404-815-4300
Practice Address - Street 1:2720 METROPOLITAN PKWY SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-7914
Practice Address - Country:US
Practice Address - Phone:404-905-9200
Practice Address - Fax:404-815-4300
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2023-09-26
Deactivation Date:2022-01-10
Deactivation Code:
Reactivation Date:2022-01-25
Provider Licenses
StateLicense IDTaxonomies
GA95691207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine