| Organization Name: | MIKE DAE WHANG MD INC |
| NPI Number: | 1164591202 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MIKE DAE WHANG (PRESIDENT) |
| Mailing Address: | 2830 Clearview Pl 210 Doraville |
| State: | GA US |
| Postal Code: | 303402134 |
| Phone Number: | 6782052670 |
| Fax Number: | 6782052671 |
| NPI Enumeration Date: | 11/06/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 040281 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |