Individual
WOOJIN KWAK KOWALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1670 CLAIRMONT RD, 5TH FLOOR SATP, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
1670 CLAIRMONT RD, 5TH FLOOR SATP, DECATUR, GA 30033-4004
(404) 321-6111
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
72649
GA
2084P0800X
Psychiatry Physician
DO1183
AL
2084P0802X
Addiction Psychiatry Physician
Primary
72649
GA
2084P0804X
Child & Adolescent Psychiatry Physician
72649
GA
390200000X
Student in an Organized Health Care Education/Training Program
129858
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151495
—
AL
05
—
225489
—
GA
Enumeration date
06/29/2009
Last updated
12/04/2017
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