Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 34.011965 | OH |
N | 207PE0004X | Emergency Medical Services | 34.011965 | OH |
NPI | 1073933057 |
---|---|
Provider Name | Michael Tang |
First Address | Toledo, OH 43608-2603 |
Second Address | Toledo, OH 43608-2603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2014 |
Last Update Date | 30/03/2017 |