Sang Wan Oh, MD
Individual provider Active NPI General Practice Physician · Reidsville, GA
NPI 1265545115 · NPPES record last updated Aug 8, 2012
Key facts
- NPI
- 1265545115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 16117 (GA)
- Practice address
- 257 South Main Street
Reidsville, GA 30427 - Phone
- (912) 557-4315
- Fax
- (912) 557-3338
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16117 | GA | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oh Clinic, P.C. | General Practice | Current |
Accepting new patients |
| Gordonia Emergency Physicians | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 16117 | GA | Yes |
Addresses
Primary practice location
257 South Main Street
Reidsville, GA 30427
Mailing address
PO Box 519
Reidsville, GA 30453
Phone (912) 557-4315
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00012317A | Medicaid | GA |
Other providers in Reidsville, GA
- Erica Logan Newberry
- NMC Holdings LLC
- Thomas O'Neill
- Kaleigh Odom
- Oh Clinic, P.C.
- Olive Care Durable Medical & Supplies, LLC.
- Optim Orthopedics, LLC
- Rebekah Hollis Parker
- Aaron Pingel
- Premise Health of Georgia Medical PC
All providers in Reidsville, GA · General Practice Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.