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Individual

MRS. SUN DUCK KWON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
721 FAIRFAX AVE, 3RD FLOOR, NORFOLK, VA 23507-2007
(757) 446-5915
(757) 446-5696
Mailing address
PO BOX 936, EVMS MEDICAL GROUP, NORFOLK, VA 23501-0936
(757) 446-5915
(757) 446-5696

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101256023
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
-017
TRICARE/CHAMPUS
VA
01
10129766
OPTIMA HEALTH
VA
01
1202589
USA MANAGED CARE
VA
01
1528383122
UNITED HEALTHCARE
VA
05
1528383122
NC
05
1528383122
VA
01
522317
ANTHEM BC/BS
VA
01
PAR
CIGNA
VA
Enumeration date
04/07/2010
Last updated
02/18/2015
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