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General NPI Number Information
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NPI Number | 1891974192
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Entity Type | Organization
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Legal Business Name | WON S LOH. MD. PC.
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 9134 COLUMBIA AVE STE A
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City | MUNSTER
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State | IN
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Zip | 46321-2907
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Country | US
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Telephone | 219-836-5550
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Fax | 219-836-2386
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Provider Business Mailing Address
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Address Line | 9134 COLUMBIA AVE STE A
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City | MUNSTER
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State | IN
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Zip | 46321-2907
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Country | US
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Telephone | 219-836-5550
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Fax | 219-836-2386
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WON S LOH
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Credential | M.D.
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Telephone | 219-836-5550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 01031576
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License Number State | IN
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