Provider Demographics
NPI:1134293681
Name:NG, HENRY (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 METROHEALTH DR
Mailing Address - Street 2:MHMC INTERNAL MEDICINE - PEDIATRICS
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1900
Mailing Address - Country:US
Mailing Address - Phone:216-778-3680
Mailing Address - Fax:216-778-1384
Practice Address - Street 1:2500 METROHEALTH DRIVE
Practice Address - Street 2:MHMC INTERNAL MEDICINE - PEDIATRICS
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1900
Practice Address - Country:US
Practice Address - Phone:216-778-3680
Practice Address - Fax:216-778-1384
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35086428207RA0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2560581Medicaid
OHI31791Medicare UPIN
OHNG7334001Medicare ID - Type Unspecified