DR. MICHAEL WONG (NPI# 1053338590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053338590 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL WONG |
| Credential | MD |
| Practice Address |
1 Childrens Pl Ste 2d Ste 2d Saint Louis MO 63110-1002 |
| Mailing Address |
660 S Euclid Ave C B 8111 Saint Louis MO 63110-1010 |
| Practice Telephone | 3144544089 |
| Practice Fax Number | 3144544225 |
| Mailing Telephone | 3144544089 |
| Mailing Fax Number | 3144544225 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-01-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 111200 | MO | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
111200 | MO | Allopathic & Osteopathic Physicians |
| N | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
111200 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 205453202 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306462411 | Michael Julian Wong | Student in an Organized Health Care Education/Training Program | University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 | 2020-06-24 |
| 1750805560 | Michael Harold Wong | Dentist | 2970 Hilltop Mall Rd Ste 212, Richmond, CA 94806-1949 | 2017-08-02 |
| 1184002537 | Michael Walter Wong | Family Medicine | 2057 State Route 130, Jeannette, PA 15644-3801 | 2015-05-18 |
| 1083010854 | Michael Yuwei Wong | Pharmacist | 419 Downey Ln, Placentia, CA 92870-7515 | 2014-11-06 |
| 1710223540 | Michael Wong | Occupational Therapy Assistant | 3901 Cathedral Ave Nw Unit 319, Washington, DC 20016-5215 | 2012-12-26 |
| 1609140730 | Michael Jun Wong | Physical Therapist | 2430 Skillman Ave, Long Island City, NY 11101-4524 | 2012-03-07 |
| 1154602621 | Michael Dennis Wong | Psychologist | 35 Memorial Rd, 12a, Somerville, MA 02145-1702 | 2011-08-29 |
| 1982919734 | Michael Kin Chung Wong | Optometrist | 6506 Loisdale Rd Ste 102, Springfield, VA 22150-1815 | 2010-08-17 |
| 1093906836 | Michael J Wong | Specialist | 201 S Alvarado St Ste 618, Los Angeles, CA 90057-2386 | 2007-08-07 |
| 1811105752 | Michael Joseph Wong | Dentist | 5400 S Central Ave, Phoenix, AZ 85040-3040 | 2007-05-21 |
| Street Address |
1 CHILDRENS PL STE 2D STE 2D |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114943347 | Helen R Race | Nurse Practitioner | 1 Childrens Pl Ste 2d, Ste 2d, Saint Louis, MO 63110-1002 | 2006-07-14 |
| 1922529171 | Kayla Rose Mcmahill | Nurse Practitioner | 1 Childrens Pl Ste 2d, Ste 2d, Saint Louis, MO 63110-1002 | 2017-06-28 |
| 1518120690 | Nico Dosenbach | Pediatrics | 1 Childrens Pl Ste 2d, Ste 2d, Saint Louis, MO 63110-1002 | 2008-07-08 |
| 1871656272 | Liu Lin Thio | Psychiatry & Neurology | 1 Childrens Pl Ste 2d, Ste 2d, Saint Louis, MO 63110-1002 | 2006-12-18 |
| 1649298332 | Ellen K Albers | Clinical Nurse Specialist | 1 Childrens Pl Ste 2d, Ste 2d, Saint Louis, MO 63110-1002 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356478705 | Robin Chanel Ryther | Psychiatry & Neurology | 1 Childrens Pl Ste D, Ste D, Saint Louis, MO 63110-1002 | 2007-02-27 |
| 1538542329 | Benjamin Paul Kay | Psychiatry & Neurology | 1 Barnes Jewish Hospital Plz, 1st Fl, Pediatric Neurology, Saint Louis, MO 63110-1003 | 2015-06-30 |
| 1023499001 | Regina Lindsay Triplett | Psychiatry & Neurology | 1 Childrens Pl, 3s34, Saint Louis, MO 63110-1002 | 2015-06-15 |
| 1881034866 | Shannon Christine Agner | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2013-07-05 |
| 1497195960 | Oleg V Lobanov | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2013-06-28 |
| 1497199640 | Keisuke Ueda | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2013-04-18 |
| 1821353756 | Bhooma Rajagopalan Aravamuthan | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2012-07-06 |
| 1437413598 | Jennifer Lynn Griffith | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2012-07-03 |
| 1215291653 | Robert John Rudock II | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2012-06-29 |
| 1184980716 | Ali Ayman Jamal | Psychiatry & Neurology | 1465 S Grand Blvd, Room 1204, Saint Louis, MO 63104 | 2012-04-09 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
Please comment or provide details below to improve the information on DR. MICHAEL WONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.