Provider Demographics
NPI:1639162969
Name:ONG, MICHAEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:ONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:224 LONGFELLOW ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VANDERGRIFT
Mailing Address - State:PA
Mailing Address - Zip Code:15690-1476
Mailing Address - Country:US
Mailing Address - Phone:724-568-5551
Mailing Address - Fax:724-568-3137
Practice Address - Street 1:224 LONGFELLOW ST
Practice Address - Street 2:SUITE 200
Practice Address - City:VANDERGRIFT
Practice Address - State:PA
Practice Address - Zip Code:15690-1476
Practice Address - Country:US
Practice Address - Phone:724-568-5551
Practice Address - Fax:724-568-3137
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2020-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD066489-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017364270001Medicaid
G91235Medicare UPIN
PA0017364270001Medicaid
PA023724Medicare PIN