Provider Demographics
NPI:1730421025
Name:LESUEUR, PATIENCE NGWANG (MD)
Entity type:Individual
Prefix:MS
First Name:PATIENCE
Middle Name:NGWANG
Last Name:LESUEUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PATIENCE
Other - Middle Name:MBORLI
Other - Last Name:NGWNAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9258 MAXWELL CROSSING
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-5030
Mailing Address - Country:US
Mailing Address - Phone:937-723-3212
Mailing Address - Fax:
Practice Address - Street 1:1740 W TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:866-600-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP216207P00000X
OH128492207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine