Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 69824 | GA |
Y | 207RC0200X | Critical Care Medicine | 69824 | GA |
NPI | 1063617413 |
---|---|
Provider Name | Jason Sanghwa Oh |
First Address | Marietta, GA 30060-9412 |
Second Address | Gainesville, GA 30501-3715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2007 |
Last Update Date | 22/04/2021 |