Provider Demographics
NPI:1851479281
Name:ONG, STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:ONG
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 1:6357 OXON HILL RD
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-2214
Mailing Address - Country:US
Mailing Address - Phone:301-839-2700
Mailing Address - Fax:301-839-1354
Practice Address - Street 1:6357 OXON HILL RD
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-2214
Practice Address - Country:US
Practice Address - Phone:301-839-2700
Practice Address - Fax:301-839-1354
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD6423208600000X
MDD014760207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD000Z87G33OtherMEDICARE PROVIDER NUMBER
MD000Z87G33OtherMEDICARE PROVIDER NUMBER