Organization
KO-AM GWINNETT MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JONG SANG WON (OWNER)
(770) 557-0203
Entity
Organization
Contact information
Practice address
6062 BUFORD HWY, SUITE 114, NORCROSS, GA 30071-2424
(770) 557-0203
(678) 395-5453
Mailing address
6062 BUFORD HWY, SUITE 114, NORCROSS, GA 30071-2424
(770) 557-0203
(678) 395-5453
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/23/2012
Last updated
08/02/2012
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