Provider Demographics
NPI:1548251127
Name:DO, DAIHUNG V (MD)
Entity type:Individual
Prefix:DR
First Name:DAIHUNG
Middle Name:V
Last Name:DO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:65 WALNUT ST
Mailing Address - Street 2:STE 520
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2191
Mailing Address - Country:US
Mailing Address - Phone:617-667-4493
Mailing Address - Fax:617-667-7435
Practice Address - Street 1:65 WALNUT ST STE 520
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2191
Practice Address - Country:US
Practice Address - Phone:781-237-3500
Practice Address - Fax:781-237-1360
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2021-12-13
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Provider Licenses
StateLicense IDTaxonomies
MA218812207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2035626Medicaid
I09465Medicare UPIN
A36996Medicare ID - Type Unspecified