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Individual

DAVID KWON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
4500 EUCLID AVE, CLEVELAND, OH 44103-3736
(216) 325-9296
Mailing address
5209 DETROIT AVE, CLEVELAND, OH 44102-2224
(216) 651-2037

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12360
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0093361
OH
Enumeration date
07/07/2011
Last updated
12/17/2013
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