PETER WONG

MOUNT VERNON, IL
NPI1952344509
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2086S0129X 
(Licence: IL  036097977)
Additional Taxonomies2086S0129X 
(Licence: MI  4301076962)
Enumeration Date2006-06-13
Last Update Date2020-10-21
Business Address
PETER WONG MD
2 GOOD SAMARITAN WAY STE 235
MOUNT VERNON, IL 62864-2476
Phone number: 618-899-3980
Mailing Address
PETER WONG MD
PO BOX 955860 MC 845
SAINT LOUIS, MO 63195-2560
Phone number: 636-498-5944
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