Individual
GUUN KWON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7150 CLEARVISTA DR, INDIANAPOLIS, IN 46256-1695
(317) 621-6262
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02006881A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q00382713
RAILROAD MEDICARE
IN
Enumeration date
06/03/2019
Last updated
01/16/2023
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