Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0207X | Pediatric Hematology-Oncologist | 159021 | MA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | N3119 | TX |
N | 2080P0208X | Pediatric Infectious Diseases | 159021 | MA |
NPI | 1316914997 |
---|---|
Provider Name | Andrew Young Koh |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 20/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
159021 | TUFTS (01) | |
3195571 | (05) | MA |
7627170 | CIGNA (01) | |
A2981 | MEDICARE (01) | |
AA11740 | HPHC DFCI ONLY (01) | |
G96437 | (02) | |
J21026 | MA BCBS (01) |