Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | MD417282 | PA |
Y | 207RH0003X | Hematology & Oncology | 036155512 | IL |
N | 207RH0003X | Hematology & Oncology | 2021030706 | MO |
N | 207RH0003X | Hematology & Oncology | MD-49003 | IA |
N | 207RX0202X | Medical Oncology | MD417282 | PA |
NPI | 1306946033 |
---|---|
Provider Name | Daniel Koh |
First Address | Quincy, IL 62301-2834 |
Second Address | Quincy, IL 62301-2834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2006 |
Last Update Date | 30/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03716745 | (05) | NY |
1034672960001 | (05) | PA |
641050PZP | MEDICARE (01) | PA |
H93695 | (02) | |
P01316383 | RAILROAD MEDICARE (01) | NY |