Individual
YONGWOO DAVID SEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-1400
(414) 955-0197
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-1400
(414) 955-0197
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
84562
WI
208600000X
Surgery Physician
T1548
TX
2086X0206X
Surgical Oncology Physician
Primary
84562
WI
2086X0206X
Surgical Oncology Physician
T1548
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528487402
—
WI
05
—
428567801
—
TX
01
—
428567802
MEDICAID-CSHCN
TX
01
—
8QD344
BCBS
TX
01
—
Q00134123
RAILROAD MEDICARE
TX
Enumeration date
04/08/2014
Last updated
10/02/2024
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