Individual
SUSAN LEE FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
3333 BURNET AVE, CINCINNATI, OH 45229-3026
(513) 636-4200
Mailing address
3333 BURNET AVE, CINCINNATI, OH 45229-3026
(513) 636-4200
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
35.136097
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2013
Last updated
05/15/2019
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