Healthcare Provider Details

I. General information

NPI: 1407559735
Provider Name (Legal Business Name): WON HUH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LAKE VIEW DR
WAUSAU WI
54403-6785
US

IV. Provider business mailing address

1900 WESTWOOD DR STE 3100
WAUSAU WI
54401-7843
US

V. Phone/Fax

Practice location:
  • Phone: 715-848-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number85503-20
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: