Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DN1855978 | MA |
Y | 1223G0001X | General Practice | DN1855978 | MA |
Y | 213EG0000X | General Practice | DN1855978 | MA |
NPI | 1003163619 |
---|---|
Provider Name | Dr. Nina Mi Hyun Oh |
First Address | Bedford, MA 01730-2021 |
Second Address | Tewksbury, MA 01876-4774 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2012 |
Last Update Date | 29/04/2020 |