Individual
JAEON KWAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(330) 493-4443
Mailing address
2301 ERWIN RD, DURHAM, NC 27705-4699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101277245
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2020
Last updated
01/05/2024
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