Provider Demographics
NPI:1255509873
Name:OGON, BERNARD OKEM (MD)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:OKEM
Last Name:OGON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:583 SHOEMAKER ROAD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4201
Mailing Address - Country:US
Mailing Address - Phone:484-378-2424
Mailing Address - Fax:484-723-5324
Practice Address - Street 1:583 SHOEMAKER ROAD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4201
Practice Address - Country:US
Practice Address - Phone:484-378-2424
Practice Address - Fax:484-723-5324
Is Sole Proprietor?:No
Enumeration Date:2008-02-16
Last Update Date:2025-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08756900207QG0300X
PAMD436175207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine