126th Street Medical
NPI #1316949787 in Ocean City, Maryland
Provider Information
- NPI Number
- 1316949787
- Entity Type
- Organization
- Organization Name
- 126th Street Medical
- Primary Specialty
- Family Medicine
- Enumeration Date
- Aug 15, 2005
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 12601 D COASTAL HIGHWAY
- City
- Ocean City
- State
- Maryland
- ZIP Code
- 21842-9784
- Phone
- (410) 250-8000
Authorized Official
- Name
- DR. VICTOR GONG, MD
- Title
- MEDICAL OFFICER
- Phone
- (410) 250-8000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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