Individual
MICHAEL SANGWOO AN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 689-8333
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016006074
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016006074
IL
Other
Enumeration date
03/27/2020
Last updated
08/07/2024
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