Individual
SOOJUNG KWON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2477
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
043249
CT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
043249
CT
208M00000X
Hospitalist Physician
Primary
01077113A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001029107
ANTHEM PROVIDER NUMBER
IN
05
—
001432492
—
CT
05
—
201373820
—
IN
Enumeration date
03/17/2006
Last updated
01/05/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us