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Individual

KONG YOUNG KWON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3700 KOLBE RD, LORAIN, OH 44053-1611
(440) 960-4000
Mailing address
578 N LEAVITT RD, C/O MMS, AMHERST, OH 44001-1131
(440) 988-1009
(440) 988-1225

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35.037196
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2689863
OH
05
2943917
OH
Enumeration date
08/06/2006
Last updated
09/28/2009
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