Provider Demographics
NPI:1396750782
Name:NGU, MONICA NGOCMAN (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:NGOCMAN
Last Name:NGU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 FIVE MILE ROAD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2189
Mailing Address - Country:US
Mailing Address - Phone:513-233-2444
Mailing Address - Fax:513-233-0621
Practice Address - Street 1:8000 FIVE MILE ROAD
Practice Address - Street 2:SUITE 250
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2189
Practice Address - Country:US
Practice Address - Phone:513-233-2444
Practice Address - Fax:513-233-0621
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071897207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2067570Medicaid
OH0854605Medicare ID - Type Unspecified
OH2067570Medicaid