Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 01058048A | IN |
NPI | 1063587830 |
---|---|
Provider Name | Dr. Mike Wooliang Chou |
First Address | Evansville, IN 47714-8002 |
Second Address | Evansville, IN 47714-8002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 25/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200883070 | (05) | IN |
G13334 | (02) |