Healthcare Provider Details

I. General information

NPI: 1104239334
Provider Name (Legal Business Name): GERALD MING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NMRTC/USNH YOKOSUKA JAPAN PSC 475
YOKOSUKA JAPAN
96350
JP

IV. Provider business mailing address

PSC 475 BOX 1
FPO AP
96350-1200
US

V. Phone/Fax

Practice location:
  • Phone: 315-243-8595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA139143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: