Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 55646 | AZ |
Y | 208600000X | Surgeon | 55646 | AZ |
N | 2082S0105X | Plastic Hand Surgeon | 55646 | AZ |
NPI | 1487953840 |
---|---|
Provider Name | Kevin D Han |
First Address | Phoenix, AZ 85004-1254 |
Second Address | Phoenix, AZ 85004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2011 |
Last Update Date | 02/07/2018 |