Provider Demographics
NPI:1598897472
Name:TAK, WON K (MD)
Entity Type:Individual
Prefix:
First Name:WON
Middle Name:K
Last Name:TAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:448 W DOERR PATH
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34442-5175
Mailing Address - Country:US
Mailing Address - Phone:508-334-6550
Mailing Address - Fax:
Practice Address - Street 1:119 BELMONT STREET
Practice Address - Street 2:U-MASS MEMORIAL MED.CENT
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605
Practice Address - Country:US
Practice Address - Phone:508-334-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA339712085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology