Individual
MICHAEL G KWOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
440 SPOTSYLVANIA TOWNE CENTRE, FREDERICKSBURG, VA 22407-1123
(540) 786-2272
(540) 786-3793
Mailing address
8123 GILROY DR, LORTON, VA 22079-2937
(443) 845-1188
(540) 786-3793
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001613
VA
152W00000X
Optometrist
OP1000135
DC
152W00000X
Optometrist
TA2010
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11643528
CAQH
VA
05
—
1164506713
—
VA
Enumeration date
10/24/2006
Last updated
12/29/2016
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