Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 35.088581 | OH |
NPI | 1689753105 |
---|---|
Provider Name | Huy Ngoc Dang |
First Address | Sandy, UT 84070-8790 |
Second Address | Massillon, OH 44646-3554 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 12/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000497135 | BC/BS OF OHIO (01) | OH |
I65475 | (02) | OH |
P00409914 | RR MEDICARE (01) | OH |