Individual
SUMIN LEE KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157
(336) 716-2011
Mailing address
2722 MERRILEE DR, STE 230, FAIRFAX, VA 22031-4400
(703) 698-4444
(703) 204-0116
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101265608
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2013
Last updated
07/01/2019
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