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General NPI Number Information
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NPI Number | 1164551990
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Entity Type | Individual
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Provider Name | YOUNG SUK OH M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/25/2011
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Provider Practice Location Address
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Address Line | 9200 W WISCONSIN AVE DIVISION OF GASTROENTEROLOGY
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City | MILWAUKEE
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State | WI
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Zip | 53226-3522
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Country | US
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Telephone | 414-805-2901
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Fax | 414-805-3885
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Provider Business Mailing Address
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Address Line | 9200 W WISCONSIN AVE DIVISION OF GASTROENTEROLOGY
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City | MILWAUKEE
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State | WI
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Zip | 53226-3522
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Country | US
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Telephone | 414-805-2901
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Fax | 414-805-3885
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 53284
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD428572
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD428572
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD00047781
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00047781
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License Number State | WA
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