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Individual

SOO YOUNG HWANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
825 N CENTER AVE, GAYLORD, MI 49735-1592
(989) 731-2201
(989) 731-2206
Mailing address
275 ROBERTS AVE APT 2, GAYLORD, MI 49735-8387
(989) 732-8844

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301048941
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050092126
RAILROAD MEDICARE
MI
01
0506900422
BLUE SHIELD
MI
05
4447615
MI
Enumeration date
09/21/2006
Last updated
02/04/2010
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