Healthcare Provider Details

I. General information

NPI: 1447458484
Provider Name (Legal Business Name): SUNG KWON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEVE KWON MD MPH

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 PARK ST
NEW HAVEN CT
06519-1110
US

IV. Provider business mailing address

330 CEDAR ST
NEW HAVEN CT
06510-3218
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-3577
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD60095338
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberML20008997
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number1.084424
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number25MA09961000
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number273373
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: