Healthcare Provider Details

I. General information

NPI: 1346656683
Provider Name (Legal Business Name): EN YAW HONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11140 MONTGOMERY RD STE 1100
CINCINNATI OH
45249-2309
US

IV. Provider business mailing address

11140 MONTGOMERY RD STE 1100
CINCINNATI OH
45249-2309
US

V. Phone/Fax

Practice location:
  • Phone: 513-206-1170
  • Fax: 513-206-1172
Mailing address:
  • Phone: 513-206-1170
  • Fax: 513-206-1172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number35.148703
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: