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NPI Code Detail

MEDICARE: MIYEON OH MD

MEDICARE: MIYEON OH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician240360NY
2207RI0200XInfectious Disease Physician240360NY
3207R00000XInternal Medicine Physician240360NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2240360-8WOTHERNYWORKER'S COMPENSATION

General Provider Information

NPI Number : 1669401253
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIYEON OH MD
Provider Business Mailing Address
First Line : 100 KINGS HWY S
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5504
Country : US
Telephone Number : 585-922-4882
Fax Number : 585-922-4936
Provider Business Practice Location Address
First Line : 1455 E RIDGE RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14621-2006
Country : US
Telephone Number : 585-922-4882
Fax Number : 585-922-4936
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 02/15/2022

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Directions to “ MIYEON OH MD” Practice Location

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