Provider Demographics
NPI:1477717080
Name:OCHIENG', MILTON OLUDHE (MD)
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:OLUDHE
Last Name:OCHIENG'
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PROGRESS POINT PKWY STE 206
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-2207
Mailing Address - Country:US
Mailing Address - Phone:636-344-1073
Mailing Address - Fax:636-344-1075
Practice Address - Street 1:20 PROGRESS POINT PKWY
Practice Address - Street 2:STE 108
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-2206
Practice Address - Country:US
Practice Address - Phone:636-344-1073
Practice Address - Fax:636-344-1075
Is Sole Proprietor?:No
Enumeration Date:2008-07-12
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014012514207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1477717080OtherNPI