Individual
JAY S HWANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
919 MAIN ST STE 101, DYER, IN 46311-3717
(219) 836-7531
(219) 836-7593
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01066795
IN
208800000X
Urology Physician
036.105084
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200963960
—
IN
Enumeration date
07/21/2005
Last updated
03/28/2023
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