Mongkol Mong, M.D.P.C.

LBN: Mongkol Mong, M.D.P.C.
Mongkol Mong, M.D.P.C. is an health care organization with primary practice located at 15332 Fort St , Southgate MI 48195-1304. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Mongkol Mong, M.D.P.C. can be contacted via phone (734) 285-2255, or through Mongkolpradit, Mongkol via phone (734) 285-2255.

Contact Information

Primary practice address
15332 Fort St Southgate MI 48195-1304
Phone: (734) 285-2255
Fax: (734) 285-9044
Website:
Map and Directions
Authorized official contact:
Name: Mongkolpradit, Mongkol Doctor of Medicine (MD)
Phone: (734) 285-2255

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MM032063 Michigan

Profile Details

NPI number 1316079452
LBN Legal business name Mongkol Mong, M.D.P.C.
DBA Doing business as
Authorized official Mongkolpradit, Mongkol Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 12th, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316079452 NPPES
Michigan MEDICAID 1421722
Michigan Other 0828033
Michigan Other MM032063

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