Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | C1-0006905 | DE |
NPI | 1053374181 |
---|---|
Provider Name | Dr. Hung Quang Dam |
First Address | Newark, DE 19718 |
Second Address | Newark, DE 19718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 16/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H86227 | (02) | DE |