Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 251971 | MA |
N | 111NI0900X | Internist | 251971 | MA |
N | 207R00000X | Internist | 35.139767 | OH |
N | 111NI0900X | Internist | 35.139767 | OH |
Y | 207RG0100X | Gastroenterologist | 35.139767 | OH |
NPI | 1003177304 |
---|---|
Provider Name | Samuel Y. Han |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210-1240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2012 |
Last Update Date | 17/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0408840 | (05) | OH |