Individual
CHUL K KWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, 1ST FL PARK AVENUE PAVILLON, PHILADELPHIA, PA 19140
(215) 707-7237
(215) 707-9389
Mailing address
PO BOX 827783, PHILADELPHIA, PA 19182-7783
(215) 707-7237
(215) 707-9389
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD032188L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017322120007
—
PA
Enumeration date
10/13/2005
Last updated
02/22/2010
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