Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 5101020130 | MI |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 04105 | KY |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 51970 | SC |
NPI | 1043574882 |
---|---|
Provider Name | Earl James Han |
First Address | Georgetown, SC 29442-4203 |
Second Address | Georgetown, SC 29440-6418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 03/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
519709 | (05) | SC |