Provider Demographics
NPI:1801872106
Name:OHKI, STEPHEN K (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:K
Last Name:OHKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 FOUNDERS PLZ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-3212
Mailing Address - Country:US
Mailing Address - Phone:860-291-6554
Mailing Address - Fax:860-528-0778
Practice Address - Street 1:111 FOUNDERS PLZ
Practice Address - Street 2:SUITE 400
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-3212
Practice Address - Country:US
Practice Address - Phone:860-291-6554
Practice Address - Fax:860-528-0778
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0300692085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010030069CT01OtherANTHEM BC/BS
CT001300699Medicaid
CTA2516306OtherOXFORD
CT010030069CT01OtherANTHEM BC/BS
CT300000884Medicare ID - Type Unspecified