Active NPI
Marc L Wong, MD
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- Honolulu, HI
National Provider Identifier
1558420570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- License
- MD9506
- Practice address
- 2228 Liliha St
Suite 208
Honolulu, HI 96817 - Phone
- (808) 548-0234
- NPI assigned
- Dec 6, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 207YX0007X | MD9506 | HI | Primary |
Addresses
Primary practice location
2228 Liliha St
Suite 208
Honolulu, HI 96817
Mailing address
2417 Round Top Dr
Honolulu, HI 96822
Phone (808) 946-4021
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060111000545 | HI | Practitioner - Otolaryngology | 8820011240 | Practice locations: Honolulu, HI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD9506 | HI | MD | Plastic Surgery within the Head & Neck (Otolaryngology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558420570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2417 ROUND TOP DR",
"city": "HONOLULU",
"state": "HI",
"postal_code": "96822",
"telephone_number": "808-946-4021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2228 LILIHA ST",
"address_2": "SUITE 208",
"city": "HONOLULU",
"state": "HI",
"postal_code": "96817",
"telephone_number": "808-548-0234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "MARC",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0007X",
"taxonomy_group": "",
"desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
"state": "HI",
"license": "MD9506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.