Provider Demographics
NPI:1770586117
Name:OH, WILLIAM Y (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:Y
Last Name:OH
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 1:1501 W CHISHOLM ST
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-1401
Mailing Address - Country:US
Mailing Address - Phone:989-356-9333
Mailing Address - Fax:989-356-0804
Practice Address - Street 1:388 YPAO RD
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3701
Practice Address - Country:US
Practice Address - Phone:671-646-8881
Practice Address - Fax:671-646-1292
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17710207X00000X
OH80045207X00000X, 207XS0106X, 207XX0801X
MI4301106667207X00000X
IN01079317A207X00000X
VA0101035843207XS0106X
GUM-2293207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100187290Medicaid
MIP39740027OtherMEDICARE PTAN
KY50035861OtherPASSPORT MEDICAID
KY81381OtherCOVENTRYCARES
VA006409458Medicaid
GUH122863OtherMEDICARE PTAN
KYK022340Medicare PIN