Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A154288 | CA |
Y | 207YP0228X | Pediatric Otolaryngology | DR.0062707 | CO |
NPI | 1164765954 |
---|---|
Provider Name | Tammy Wang |
First Address | Denver, CO 80204-4507 |
Second Address | Denver, CO 80204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2013 |
Last Update Date | 02/03/2021 |