Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MD11190 | OR |
NPI | 1184601593 |
---|---|
Provider Name | Thomas A Kahan |
First Address | Salem, OR 97301-3891 |
Second Address | Salem, OR 97301-3891 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2005 |
Last Update Date | 12/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
022434 | (05) | OR |
C92996 | (02) |