Individual
YONG KU KWON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5677 BUFORD HWY NE STE 210, DORAVILLE, GA 30340-1200
(678) 547-1045
(678) 547-1048
Mailing address
5677 BUFORD HWY NE STE 210, DORAVILLE, GA 30340-1200
(678) 547-1045
(678) 547-1048
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004834
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379290255A
—
GA
05
—
379290255B
—
GA
Enumeration date
10/03/2006
Last updated
01/11/2010
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