Individual
BONG S KAUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4242 COBBLESTONE DR, COPLEY, OH 44321-2925
(330) 666-5617
(330) 666-5657
Mailing address
111 STOW AVE STE 200, CUYAHOGA FALLS, OH 44221-2560
(330) 564-2629
(330) 546-7758
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
35057848
OH
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
35057848
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000561240
ANTHEM
OH
05
—
0809647
—
OH
01
—
P00478827
RAILROAD MEDICARE
OH
Enumeration date
03/22/2006
Last updated
06/23/2020
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