Individual
WONWOO SHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1600 SW ARCHER RD, BOX 100275, GAINESVILLE, FL 32610-0275
(352) 273-7841
Mailing address
PO BOX 100275, GAINESVILLE, FL 32610-0275
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
52067
MN
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
OS12056
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
52067
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008876900
—
FL
05
—
ENROLLED
—
MN
Enumeration date
07/15/2008
Last updated
08/06/2013
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