Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 222139-1 | NY |
N | 111NI0900X | Internist | 222139-1 | NY |
N | 207RG0100X | Gastroenterologist | 036-145175 | IL |
N | 207RG0100X | Gastroenterologist | 222139-1 | NY |
Y | 207RG0100X | Gastroenterologist | 68825-20 | WI |
NPI | 1053370353 |
---|---|
Provider Name | Steven S. Yang |
First Address | Beloit, WI 53511-1842 |
Second Address | Beloit, WI 53511-1842 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 28/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02666388 | (05) | NY |
100075087 | (05) | WI |
I36461 | (02) | NY |