Provider Demographics
NPI:1336330224
Name:NGO, KHA (DO)
Entity Type:Individual
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First Name:KHA
Middle Name:
Last Name:NGO
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Gender:M
Credentials:DO
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Mailing Address - Street 1:26850 PROVIDENCE PKWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1213
Mailing Address - Country:US
Mailing Address - Phone:248-662-4110
Mailing Address - Fax:248-662-4120
Practice Address - Street 1:26850 PROVIDENCE PKWY
Practice Address - Street 2:SUITE 350
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1213
Practice Address - Country:US
Practice Address - Phone:248-662-4110
Practice Address - Fax:248-662-4120
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2014-09-22
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Provider Licenses
StateLicense IDTaxonomies
MI5101017406207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI020F338090OtherBLUE CROSS BLUE SHIELD MI
MI01336330OtherHEALTH PLUS OF MI
MI1336330224OtherPRIORITY HEALTH
MI1336330224OtherAETNA
MI1336330224OtherHUMANA
MI1336330224OtherST JOHN SMART HEALTH
MI5632805OtherBLUE CARE NETWORK
MI1336330224OtherAARP
MI4307482OtherCIGNA
1336330224OtherHEALTH ALLIANCE PLAN (HAP)
MI1336330224OtherUNITED HEALTHCARE
MI1336330224Medicaid
MI1336330224OtherHUMANA