Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | RTP 001740 | GA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 062220 | GA |
NPI | 1821295171 |
---|---|
Provider Name | Tsung Ming Hsu |
First Address | Athens, GA 30606-2797 |
Second Address | Athens, GA 30606-2797 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 19/01/2018 |