Healthcare Provider Details

I. General information

NPI: 1669401329
Provider Name (Legal Business Name): HWANG R KUO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 HAPPY ACRES RD
CHESAPEAKE VA
23323-2110
US

IV. Provider business mailing address

4053 TAYLOR RD SUITE K
CHESAPEAKE VA
23321-5537
US

V. Phone/Fax

Practice location:
  • Phone: 757-485-5027
  • Fax: 757-485-9163
Mailing address:
  • Phone: 757-638-0085
  • Fax: 757-686-3025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101022303
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: