Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35-127576 | OH |
N | 111NI0900X | Internist | 35-127576 | OH |
Y | 208000000X | Pediatrician | 35-127576 | OH |
N | 2080P0204X | Pediatric Emergency Doctor | 35127576 | OH |
NPI | 1023436946 |
---|---|
Provider Name | Sara Winn Dong |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2014 |
Last Update Date | 08/06/2018 |