Individual
THAN N OO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
521 E MICHIGAN AVE, SUITE 201, KALAMAZOO, MI 49007-3889
(269) 349-6759
(269) 349-7450
Mailing address
521 E MICHIGAN AVE, SUITE 201, KALAMAZOO, MI 49007-3889
(269) 349-6759
(269) 349-7450
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301067357
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104481555
—
MI
05
—
104871612
—
MI
01
—
1103901030
BCBS INDIVIDUAL
MI
Enumeration date
05/10/2006
Last updated
11/09/2023
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