Provider Demographics
NPI:1093349011
Name:HUH, DAVID (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:HUH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 E GOLDEN LN
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-4510
Mailing Address - Country:US
Mailing Address - Phone:847-636-8836
Mailing Address - Fax:
Practice Address - Street 1:3233 S 27TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4301
Practice Address - Country:US
Practice Address - Phone:414-671-3660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17328-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist