Healthcare Provider Details

I. General information

NPI: 1346292133
Provider Name (Legal Business Name): I CHENG HO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS STREET BRIGHAM AND WOMENS HOSPITAL RHEUMATOLOGY IMMUN ALLERGY
BOSTON MA
02115
US

IV. Provider business mailing address

1 JIMMY FUND WAY SMITH BLDG 5TH FLOOR
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-5500
  • Fax:
Mailing address:
  • Phone: 617-732-5325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number151950
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: