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Individual

MR. SANG WAN OH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
257 SOUTH MAIN STREET, REIDSVILLE, GA 30427
(912) 557-4315
(912) 557-3338
Mailing address
PO BOX 519, REIDSVILLE, GA 30453
(912) 557-4315
(912) 557-3338

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
16117
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00012317A
GA
Enumeration date
08/16/2006
Last updated
08/08/2012
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