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MR. SANG WAN OH MD
>> General Practice >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1265545115
Individual Registrant:MR. SANG WAN OH MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
257 SOUTH MAIN STREET REIDSVILLE, GA 30427 US
Tel: 912-557-4315 Fax: 912-557-3338
Tel: 912-557-4315 Fax: 912-557-3338
Contact information for business:
PO BOX 519 REIDSVILLE, GA 30453 US
Tel: 912-557-4315 Fax: 912-557-3338
Tel: 912-557-4315 Fax: 912-557-3338
Registration Information:
NPI: 1265545115
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 208D00000X | Allopathic & Osteopathic Physicians General Practice | GA | 16117 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 00012317A | GA | 05 |
