Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301040549 | MI |
N | 111NI0900X | Internist | 4301040549 | MI |
Y | 207RG0100X | Gastroenterologist | 4301040549 | MI |
NPI | 1033292966 |
---|---|
Provider Name | Chung Owyang |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5362 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 27/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1336256 | (05) | MI |
A78241 | (02) | MI |