Individual
JACKY KWONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DRIVE, 5344 CVC, ANN ARBOR, MI 48109-5864
(734) 936-4973
Mailing address
1500 E MEDICAL CENTER DRIVE, 5344 CVC, ANN ARBOR, MI 48109-5030
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125.077926
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
4351053810
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/28/2019
Last updated
07/07/2025
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