Healthcare Provider Details

I. General information

NPI: 1447954698
Provider Name (Legal Business Name): SEJOONG KANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVID KANG MD

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3276 BUFORD DR STE 100
BUFORD GA
30519-5702
US

IV. Provider business mailing address

3276 BUFORD DR STE 100
BUFORD GA
30519-5702
US

V. Phone/Fax

Practice location:
  • Phone: 404-251-2890
  • Fax: 678-714-0496
Mailing address:
  • Phone: 404-251-2890
  • Fax: 678-714-0496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number101929
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: