MEDICARE: KHANH V. DANG, MD, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35065651	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0407186	OTHER	OH	UHC
3	280764512006	OTHER	OH	MEDICAL MUTUAL
4	000000249487	OTHER	OH	ANTHEM
5	5717134	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1447286570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KHANH V. DANG, MD, LLC

Provider Business Mailing Address
First Line	:	1151 BETHEL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-2775
Country	:	US
Telephone Number	:	614-451-5088
Fax Number	:	614-451-4185

Provider Business Practice Location Address
First Line	:	1151 BETHEL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-2775
Country	:	US
Telephone Number	:	614-451-5088
Fax Number	:	614-451-4185

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	KAY FOX
Credential	:
Telephone Number	:	614-451-5088

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	10/15/2007

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