Provider Demographics
NPI:1528030293
Name:NG, ROLAND (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:
Last Name:NG
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 1:2055 NORMANDIE DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-2732
Mailing Address - Country:US
Mailing Address - Phone:334-269-6337
Mailing Address - Fax:334-834-0657
Practice Address - Street 1:2055 NORMANDIE DR
Practice Address - Street 2:108
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-2732
Practice Address - Country:US
Practice Address - Phone:334-288-4624
Practice Address - Fax:334-280-3628
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000256092085R0202X
ALMD 256092085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL108289Medicaid
AL108567Medicaid
FL271641100Medicaid
AL000058867OtherIDTF
AL009947465Medicaid
AL009947475Medicaid
AL009947485Medicaid
AL009947425Medicaid
AL009947455Medicaid
AL107013Medicaid
AL009947435Medicaid
AL009947515Medicaid
AL009947445Medicaid
AL009947495Medicaid
AL009947535Medicaid
AL051504364OtherIDTF
AL009947505Medicaid
AL009947525Medicaid
AL107016Medicaid
AL000058867OtherIDTF
AL009947445Medicaid
AL108289Medicaid
AL107016Medicaid
AL051520951Medicare PIN