Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 35084990 | OH |
NPI | 1114978012 |
---|---|
Provider Name | Sung K Min |
First Address | Cincinnati, OH 45211-4307 |
Second Address | Cincinnati, OH 45211-4307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 16/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201047290A | (05) | IN |
2529946 | (05) | OH |
616164000 | US DEPT OF LABOR (01) | OH |
64122294 | (05) | KY |
G39535 | (02) |