Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 19713 | GA |
NPI | 1174687404 |
---|---|
Provider Name | Dr. Max Kuo |
First Address | Albany, GA 31721-9203 |
Second Address | Albany, GA 31701-1333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 08/07/2007 |