Provider Demographics
NPI:1689719528
Name:ONGEMACH, JEFFREY WADE (BS, CG IDHS, NREMT-I)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:WADE
Last Name:ONGEMACH
Suffix:
Gender:M
Credentials:BS, CG IDHS, NREMT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMDT CG-1122 U S COAST GUARD
Mailing Address - Street 2:2100 2ND ST SW, SUITE 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:COMDT CG-1122 U S COAST GUARD
Practice Address - Street 2:2100 2ND ST SW, SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:202-267-0801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X, 1710I1003X
OHNREMT-I0682827146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate