Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 7890 | NH |
NPI | 1083667141 |
---|---|
Provider Name | Paul C Tung |
First Address | Dover, NH 03820-2526 |
Second Address | Dover, NH 03820-5933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 25/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083667141 | (05) | ME |
3076045 | (05) | NH |
A93012 | (02) | NH |