Provider Demographics
NPI:1215994900
Name:MONGEY, ANN BARBARA (MD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:BARBARA
Last Name:MONGEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 VICTORY PKWY
Mailing Address - Street 2:STE 310
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-3700
Mailing Address - Country:US
Mailing Address - Phone:513-245-3444
Mailing Address - Fax:513-245-3449
Practice Address - Street 1:3130 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2333
Practice Address - Country:US
Practice Address - Phone:513-584-4061
Practice Address - Fax:513-584-2599
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-062267207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64868557Medicaid
OH0846393Medicaid
OH0846393Medicaid
OHMO0702771Medicare PIN