Provider Demographics
NPI:1790340511
Name:HAN, WOOJIN
Entity Type:Individual
Prefix:
First Name:WOOJIN
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:1301 TAYLOR ST STE 8A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2955
Practice Address - Country:US
Practice Address - Phone:803-929-2955
Practice Address - Fax:803-929-2979
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2023-07-18
Deactivation Date:2020-03-27
Deactivation Code:
Reactivation Date:2020-04-08
Provider Licenses
StateLicense IDTaxonomies
SC90048207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine