Basic Information
| Provider Information | |||||||||
| NPI: | 1215167960 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGU | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | FOLENG | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 LIPPINCOTT DR STE 410 | ||||||||
| Address2: | |||||||||
| City: | MARLTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080534197 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563550340 | ||||||||
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| Practice Location | |||||||||
| Address1: | 305 ROUTE 70 E STE A | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080342408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563756243 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2009 | ||||||||
| LastUpdateDate: | 08/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 25MA09132500 | NJ | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 25MA09132500 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.