Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark Wong, MD

Individual provider Internal Medicine Physician · NPI 1821054081

Mark Wong, MD is a Gastroenterology in Phoenix, Arizona. Graduated from Loma Linda University School of Medicine in 2000, 26 years ago. Practices with Banner - University Super Specialists LLC, a 32-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
26
Trained at
Loma Linda University School of Medicine
Licensed in
AZ
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1441 N 12th St
Phoenix, AZ 85006-2837
Phone: (602) 521-5800
Fax: (602) 521-5334
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 32916 (AZ)

Record details

NPI number1821054081
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 25, 2006
Last updated in NPPESDecember 2, 2016
Mailing address1441 N 12th St, Phoenix, AZ 85006-2837

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGASTROENTEROLOGY
Also practisesINTERNAL MEDICINE
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2000 (26 years in practice)
Group practice Banner - University Super Specialists Llc — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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