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General NPI Number Information
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NPI Number | 1487840872
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Entity Type | Individual
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Provider Name | EDWARD KWANG YI M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1 WYOMING ST
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City | DAYTON
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State | OH
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Zip | 45409-2722
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Country | US
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Telephone | 937-709-5051
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Fax | 937-709-5050
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Provider Business Mailing Address
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Address Line | PO BOX 750243
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City | DAYTON
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State | OH
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Zip | 45475-0243
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Country | US
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Telephone | 937-709-5051
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Fax | 937-709-5050
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 11631
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01074532A
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License Number State | IN
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