NPI 1265060149 · live from the CMS NPI Registry
Michael Sangwoo An, DPM
Podiatrist, Foot & Ankle Surgery in Stony Brook, NY. National Provider Identifier 1265060149, active.
NPI record
| NPI | 1265060149 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 101 Nicolls Rd, Stony Brook, NY 11794 |
| Practice phone | 631-689-8333 |
| Mailing address | Po Box 3988, Carbondale, IL 62902 |
| Enumerated | March 27, 2020 |
| Last updated | August 7, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | 016006074 (IL) |
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 016006074 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.