Matthew Ven-Fung Wong, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5151015929 Issued in MI

Practice address

2055 E 14 Mile Rd
Birmingham, MI 48009-7256

Phone

(248) 645-1740

Fax

(248) 645-5304

NPI assigned

May 16, 2022

Last updated

Jun 30, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19827/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Detroit Wayne County Health Authority

  • Primary Care Clinic/Center
  • Detroit, MI
  • NPI 1962733089
  NPD
• Bloom Pediatrics PC

  dba Eastman, Wozniak, Groebe Pediatrics P.C.

  • Pediatrics Physician
  • Birmingham, MI
  • NPI 1043364680
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1790422343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E 14 MILE RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097256",
            "telephone_number": "248-645-1740",
            "fax_number": "248-645-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E 14 MILE RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097256",
            "telephone_number": "248-645-1740",
            "fax_number": "248-645-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "MATTHEW",
        "middle_name": "VEN-FUNG",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-16",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5151015929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Allen Willett, PH.D.
• William C. Horton, Psy.D., PC
• William J Vasileff MD PC
• Erin Ellen Williams
• Qiana Wimbley
• Danyeil J Woods, MA.,LLMFT
• Woodward Detroit CVS, L.L.C. (CVS Pharmacy #08136)
• Maria Wozniak, M.D.
• Suhad Yaldo, MD
• Latoya Young

• Pediatrics Physician in Birmingham, MI
• Providers in Birmingham, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.