Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 01026580A | IN |
NPI | 1538140389 |
---|---|
Provider Name | Liang Yeh Frank Wu |
First Address | Indianapolis, IN 46260-2074 |
Second Address | Indianapolis, IN 46260-2074 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 04/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100058050A | (05) | IN |
C24265 | (02) |