Provider Demographics
NPI:1972962801
Name:AUNG, HENRY DAVID
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:DAVID
Last Name:AUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 ORANGE AVE W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-4532
Mailing Address - Country:US
Mailing Address - Phone:612-723-8577
Mailing Address - Fax:
Practice Address - Street 1:88 ORANGE AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-4532
Practice Address - Country:US
Practice Address - Phone:612-723-8577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-20
Last Update Date:2016-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver