Provider Demographics
NPI:1104282854
Name:DU, HAN MING (AP DOM)
Entity type:Individual
Prefix:
First Name:HAN MING
Middle Name:
Last Name:DU
Suffix:
Gender:M
Credentials:AP DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15300 JOG RD STE 209
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2166
Mailing Address - Country:US
Mailing Address - Phone:561-381-3303
Mailing Address - Fax:561-381-3303
Practice Address - Street 1:15300 JOG RD STE 209
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2166
Practice Address - Country:US
Practice Address - Phone:561-381-3303
Practice Address - Fax:561-381-3303
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP968261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center