Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 37236 | IA |
Y | 2080P0216X | Pediatric Rheumatologist | 37236 | IA |
N | 2080P0216X | Pediatric Rheumatologist | A82538 | CA |
NPI | 1245353242 |
---|---|
Provider Name | Dr. Sandy D Hong |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 21/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
56547 | WELLMARK BCBS (01) | IA |