Individual
EDWARD PARK KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
460 NORTHSIDE CHEROKEE BLVD STE 100, CANTON, GA 30115-8017
(770) 292-3490
(770) 721-5615
Mailing address
980 JOHNSON FY RD NE, STE 1040, ATLANTA, GA 30342-1626
(770) 292-3496
(404) 300-2317
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301086626
MI
2086S0129X
Vascular Surgery Physician
54147
MN
2086S0129X
Vascular Surgery Physician
Primary
70309
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003135923A
—
GA
05
—
003135923B
—
GA
05
—
003135923D
—
GA
Enumeration date
12/13/2007
Last updated
04/27/2021
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