Provider Demographics
NPI:1770554412
Name:WONG, WESLEY LUKE (MD)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:LUKE
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1710 E WEST RD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-2317
Mailing Address - Country:US
Mailing Address - Phone:808-956-8965
Mailing Address - Fax:808-956-5834
Practice Address - Street 1:1710 E WEST RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-2317
Practice Address - Country:US
Practice Address - Phone:808-956-8965
Practice Address - Fax:808-956-5834
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI6531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine