Provider Demographics
NPI:1295474047
Name:SHEY, NGOZHI TERENCE
Entity type:Individual
Prefix:
First Name:NGOZHI
Middle Name:TERENCE
Last Name:SHEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 PRENTIS HOUSE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4016
Mailing Address - Country:US
Mailing Address - Phone:614-500-2420
Mailing Address - Fax:
Practice Address - Street 1:85 MCNAUGHTEN RD STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-5111
Practice Address - Country:US
Practice Address - Phone:614-627-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH436947163W00000X
OH0031415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
15589003OtherCAQH