MEDICARE: WONHONG DAVID MIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	19641	OK
2	207T00000X	Neurological Surgery Physician	8937A	WY
3	207T00000X	Neurological Surgery Physician	16633	ND
4	207T00000X	Neurological Surgery Physician	7915443-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053304204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WONHONG DAVID MIN MD

Provider Business Mailing Address
First Line	:	PO BOX 5010
Second Line	:
City	:	MINOT
State	:	ND
Zip	:	58702-5010
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3838 S 700 E STE 300A
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-1496
Country	:	US
Telephone Number	:	801-261-4988
Fax Number	:	801-269-9425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	09/24/2025

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Directions to “ WONHONG DAVID MIN MD” Practice Location

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