Provider Demographics
NPI:1730401415
Name:OH, JIWON (BSC, MD)
Entity type:Individual
Prefix:DR
First Name:JIWON
Middle Name:
Last Name:OH
Suffix:
Gender:F
Credentials:BSC, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 ELM ST. #300
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ON
Mailing Address - Zip Code:M5G1H2
Mailing Address - Country:CA
Mailing Address - Phone:416-315-0691
Mailing Address - Fax:
Practice Address - Street 1:67 ELM ST. #300
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:ON
Practice Address - Zip Code:M5G1H2
Practice Address - Country:CA
Practice Address - Phone:416-315-0691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program