Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 5101019069 | MI |
NPI | 1043548514 |
---|---|
Provider Name | Dr. Saw San |
First Address | El Paso, TX 79934-3350 |
Second Address | El Paso, TX 79916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2009 |
Last Update Date | 04/08/2011 |