Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | MD422431 | PA |
N | 208200000X | Surgeon | MD422431 | PA |
N | 208600000X | Surgeon | MD422431 | PA |
NPI | 1114993748 |
---|---|
Provider Name | Ngoc L Thai |
First Address | Monroeville, PA 15146-3555 |
Second Address | Monroeville, PA 15146-3555 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 06/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101000910 | (05) | PA |
3810001235 | (05) | WV |
I03393 | (02) | PA |