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NPI Code Detail

MEDICARE: DR. MIKYONG HAND MD

MEDICARE: DR. MIKYONG HAND MD
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
1207Q00000XFamily Medicine PhysicianDR.0042785CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376642488
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIKYONG HAND MD
Provider Business Mailing Address
First Line : PO BOX 9049
Second Line :
City : BOULDER
State : CO
Zip : 80301-9049
Country : US
Telephone Number : 303-415-4751
Fax Number : 303-415-4769
Provider Business Practice Location Address
First Line : 1000 W SOUTH BOULDER RD STE 110
Second Line :
City : LAFAYETTE
State : CO
Zip : 80026-2753
Country : US
Telephone Number : 303-415-4355
Fax Number : 303-666-1982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 10/06/2022

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