Healthcare Provider Details

I. General information

NPI: 1033185731
Provider Name (Legal Business Name): INZUNE KIM HWANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 PRETORIA PL
WASHINGTON DC
20521-9300
US

IV. Provider business mailing address

9300 PRETORIA PL APT 25
DULLES VA
20189-9300
US

V. Phone/Fax

Practice location:
  • Phone: 979-429-3299
  • Fax: 531-200-7464
Mailing address:
  • Phone: 979-429-3299
  • Fax: 531-200-7464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberQ4772
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38853020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: