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Individual

DR. SAM CHADWELL KANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D. (OPTOMETRIST)

Contact information

Practice address
3601 29TH AVE SW, CEDAR RAPIDS, IA 52404-3109
(319) 390-9969
Mailing address
3601 29TH AVE SW, CEDAR RAPIDS, IA 52404-3109
(319) 390-9969

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02295
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
WELLMARK 38635
OPTOMETRY
IA
Enumeration date
01/17/2006
Last updated
06/27/2008
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