Provider Demographics
NPI:1174542617
Name:MING, JEFFREY E (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:E
Last Name:MING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9258
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA - GENETICS
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-2920
Practice Address - Fax:215-590-3298
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD055968L208000000X, 207SG0201X, 207SG0202X, 207SG0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207SG0202XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Biochemical Genetics
No207SG0205XAllopathic & Osteopathic PhysiciansMedical GeneticsPh.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001835040Medicaid
NJ7591802Medicaid
PA001835040Medicaid
PA001835040Medicaid