Provider Demographics
NPI:1417375122
Name:NG, SHEUNG CHEE THOMAS (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:SHEUNG CHEE THOMAS
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:55 FRUIT STREET
Mailing Address - Street 2:MGH MGPO
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-6007
Mailing Address - Country:US
Mailing Address - Phone:857-307-0866
Mailing Address - Fax:617-394-3209
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-0288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA2703372085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program