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General NPI Number Information
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NPI Number | 1982868329
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Entity Type | Individual
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Provider Name | WONWOO SHON DO
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Gender | Male
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 08/06/2013
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD BOX 100275
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City | GAINESVILLE
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State | FL
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Zip | 32610-0275
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Country | US
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Telephone | 352-273-7841
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100275
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City | GAINESVILLE
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State | FL
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Zip | 32610-0275
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Country | US
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Telephone |
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Fax |
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 52067
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 52067
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | OS12056
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License Number State | FL
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