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Individual

DR. SANG WON DACRI-KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1970 TAMARACK RD., NEWARK, OH 43055
(740) 344-2452
(740) 522-7305
Mailing address
1970 TAMARACK RD., NEWARK, OH 43055
(740) 344-2452
(740) 522-7305

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
34006602
OH
2086S0129X
Vascular Surgery Physician
Primary
34006602
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2028577
OH
01
P00397004
RAILROAD MEDICARE
OH
Enumeration date
11/21/2006
Last updated
11/23/2010
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