Individual
DR. UMENG DAVID THAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
604 BIELENBERG DR, SUITE 250, WOODBURY, MN 55125-1414
(651) 730-4100
(651) 730-4107
Mailing address
604 BIELENBERG DR, SUITE 250, WOODBURY, MN 55125-1414
(651) 730-4100
(651) 730-4107
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
47379
MN
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
47379
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
430093900
—
MN
Enumeration date
11/06/2006
Last updated
12/06/2012
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