Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301062502 | MI |
Y | 2080P0214X | Pediatric Pulmonologist | 35096852 | OH |
N | 2080P0214X | Pediatric Pulmonologist | 4301062502 | MI |
NPI | 1528074705 |
---|---|
Provider Name | Wan Chong Tsai |
First Address | East Lansing, MI 48824-7015 |
Second Address | East Lansing, MI 48823-5376 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 10/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07089 | PARAMOUNT (01) | OH |
1528074705 | (05) | MI |
2083392 | (05) | OH |
3515022 | (05) | MI |
5243688 | AETNA (01) | OH |