Organization
BRIAN KWON, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN KWON M.D. (OWNER)
(617) 754-6486
Entity
Organization
Contact information
Practice address
125 PARKER HILL AVE, CONVERSE 4, ROXBURY CROSSING, MA 02120-2847
(617) 754-6586
(617) 754-5593
Mailing address
125 PARKER HILL AVE, CONVERSE 4, ROXBURY CROSSING, MA 02120-2847
(617) 754-6586
(617) 754-5593
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
216761
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470668
TUFTS
MA
05
—
9733370
—
MA
01
—
AA16221
HPHC
MA
01
—
M18822
BCBS MA
MA
Enumeration date
10/07/2005
Last updated
10/14/2014
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