Basic Information
Provider Information
NPI: 1043257173
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUH
FirstName: WARNER
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 55310
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352555310
CountryCode: US
TelephoneNumber: 2057319701
FaxNumber:  
Practice Location
Address1: 619 19TH STREET SOUTH
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 35233
CountryCode: US
TelephoneNumber: 2059344011
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/31/2006
LastUpdateDate: 08/31/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VX0201X22644ALY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology

ID Information
IDTypeStateIssuerDescription
00993279705AL MEDICAID
05153905101ALBLUE CROSSOTHER
13054005AL MEDICAID
00996914505AL MEDICAID
16004785201ALRAILROAD MEDICAREOTHER
00009282001ALBLUE CROSSOTHER
00991030805AL MEDICAID
00009282005AL MEDICAID
00991169605AL MEDICAID
05153016201ALBLUE CROSSOTHER
05154325601ALBLUE CROSSOTHER
05152430401ALBLUE CROSSOTHER
H0928601ALVIVAOTHER
0053055005MS MEDICAID


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