Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 37699 | AL |
Y | 111NI0900X | Internist | 37699 | AL |
NPI | 1003159781 |
---|---|
Provider Name | Heeeun Kang |
First Address | Huntsville, AL 35804-2705 |
Second Address | Madison, AL 35758-1866 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2013 |
Last Update Date | 19/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
225815 | (05) | AL |