Provider Demographics
NPI:1194802454
Name:HO, WINSTON (MD)
Entity type:Individual
Prefix:DR
First Name:WINSTON
Middle Name:
Last Name:HO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:38429 LAKE SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-7009
Mailing Address - Country:US
Mailing Address - Phone:440-946-9200
Mailing Address - Fax:440-946-9208
Practice Address - Street 1:38429 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-7009
Practice Address - Country:US
Practice Address - Phone:440-946-9200
Practice Address - Fax:440-946-9208
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-5285H207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHF59340Medicare UPIN