Provider Demographics
NPI:1861473910
Name:PAIK, WOO HYUN (MD)
Entity Type:Individual
Prefix:
First Name:WOO
Middle Name:HYUN
Last Name:PAIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 S MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:OH
Mailing Address - Zip Code:44890-1408
Mailing Address - Country:US
Mailing Address - Phone:419-935-0187
Mailing Address - Fax:419-935-0200
Practice Address - Street 1:218 S MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:OH
Practice Address - Zip Code:44890-1408
Practice Address - Country:US
Practice Address - Phone:419-935-0187
Practice Address - Fax:419-935-0200
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-9181-P207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0529968Medicaid
OHPA0545981Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER