Physician Compare National (NPI:1477729051)

HEALTHCARE PROVIDER: MICHAEL ROBERT AHO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1477729051
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022271568
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130604000122
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AHO
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	NORTHSIDE RADIOLOGY ASSOCIATES LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4486555398
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	91
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2706 WATSON BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE D
	Group Practice or individual's line 2 address
City	WARNER ROBINS
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	310938034
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4789536033
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110192
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	EASTSIDE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110087
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GWINNETT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y