Healthcare Provider Details

I. General information

NPI: 1154399293
Provider Name (Legal Business Name): 8TH MEDGRP-KUNSAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8TH MEDICAL GROUP SGSBR UNIT # 2022
APO 1
AP
KR

IV. Provider business mailing address

8TH MEDICAL GROUP SGSG UNIT # 2022
APO 1
AP
KR

V. Phone/Fax

Practice location:
  • Phone: 01182634700385
  • Fax: 5732
Mailing address:
  • Phone: 01182634700385
  • Fax: 5732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1100X
TaxonomyMilitary/U.S. Coast Guard Outpatient Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEN LEWANDOWSKI
Title or Position: DHA FINANCIAL MANAGER
Credential:
Phone: 703-817-4030