Individual
KWEON STAMBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
147259
NY
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
147259
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02660066
—
NY
Enumeration date
11/15/2005
Last updated
09/12/2017
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