Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35078858 | OH |
NPI | 1144255340 |
---|---|
Provider Name | Dr. David Hoang |
First Address | Upper Arlington, OH 43220-2246 |
Second Address | Delaware, OH 43015-1405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 10/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0274064 | (05) | OH |
9935131 | MEDICARE (01) | OH |
H79732 | (02) |