Provider Demographics
NPI:1437192374
Name:HO, SAMPSON WUN-SANG (MD)
Entity type:Individual
Prefix:DR
First Name:SAMPSON
Middle Name:WUN-SANG
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 1:350 LAFAYETTE AVE SE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4656
Mailing Address - Country:US
Mailing Address - Phone:616-459-0801
Mailing Address - Fax:616-459-4065
Practice Address - Street 1:350 LAFAYETTE AVE SE
Practice Address - Street 2:SUITE 301
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4656
Practice Address - Country:US
Practice Address - Phone:616-459-0801
Practice Address - Fax:616-459-4065
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301041678208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1677193Medicaid
MISH041678OtherSTATE LICENSE
MI1677193Medicaid
MISH041678OtherSTATE LICENSE