Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 20500 | MA |
NPI | 1023016748 |
---|---|
Provider Name | Dr. Michael Alan Kahn |
First Address | Decatur, GA 30033-5918 |
Second Address | Decatur, GA 30033-5918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 19/11/2015 |