Provider Demographics
NPI:1467468959
Name:OH, SANG H (MD)
Entity Type:Individual
Prefix:DR
First Name:SANG
Middle Name:H
Last Name:OH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 S WENONA ST
Mailing Address - Street 2:SUITE #291
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-8820
Mailing Address - Country:US
Mailing Address - Phone:989-892-5548
Mailing Address - Fax:989-892-0859
Practice Address - Street 1:200 S WENONA ST
Practice Address - Street 2:SUITE #291
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-8820
Practice Address - Country:US
Practice Address - Phone:989-892-5548
Practice Address - Fax:989-892-0859
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIS0035683207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2104980Medicaid
MIA77222Medicare UPIN
MI0090002Medicare ID - Type Unspecified