Individual ProviderRichard WongInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address2500 Metrohealth Dr, Cleveland, OH 44109-1900(216) 778-7800PECOS EnrollmentBased on the most recent information from CMS, provider Richard Wong is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1760402838Provider TypeIndividualFull NameWong, RichardCredentialMDGenderMaleSole ProprietorNoEnumeration Date7/20/2006Last Updated11/6/2023Contact InformationPractice LocationPractice Address2500 Metrohealth Dr, Cleveland, OH 44109-1900Phone(216) 778-7800FaxUnlisted FaxMailing LocationMailing Address2500 Metrohealth Dr, Cleveland, OH 44109-1900PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207RG0100XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense35-070802OhioProvider IdentifiersIDDescriptionIssuerID741795DescriptionOtherIssuerBUCKEYEOhioID100009832DescriptionOtherIssuerRAILROAD MEDICAREOhioID0653493DescriptionOtherIssuerAETNAOhioID364147DescriptionOtherIssuerWELLCAREOhioID0289218DescriptionMedicaidIssuerUnlistedOhioID000000224344DescriptionOtherIssuerUNISONOhioID000000539525DescriptionOtherIssuerANTHEMOhio