Provider Demographics
NPI:1871798801
Name:M H PHILLIP CHIANG MD INC
Entity type:Organization
Organization Name:M H PHILLIP CHIANG MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:M H PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-946-5151
Mailing Address - Street 1:36001 EUCLID AVE
Mailing Address - Street 2:B 4
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4643
Mailing Address - Country:US
Mailing Address - Phone:440-946-5151
Mailing Address - Fax:440-946-8841
Practice Address - Street 1:36001 EUCLID AVE
Practice Address - Street 2:B 4
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4643
Practice Address - Country:US
Practice Address - Phone:440-946-5151
Practice Address - Fax:440-946-8841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2831449Medicaid
OH2831449Medicaid
OH9369661Medicare PIN