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General NPI Number Information
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NPI Number | 1437512134
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Entity Type | Individual
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Provider Name | BYUNG HOON BAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 989 LAWRENCEVILLE HWY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4702
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Country | US
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Telephone | 770-962-1616
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Fax | 770-962-7977
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Provider Business Mailing Address
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Address Line | 989 LAWRENCEVILLE HWY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4702
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Country | US
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Telephone | 770-962-1616
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Fax | 770-962-7977
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 88426
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License Number State | GA
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