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General NPI Number Information
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NPI Number | 1215049937
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Entity Type | Individual
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Provider Name | PETER OH-KYUNG KWON M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/11/2008
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Provider Practice Location Address
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Address Line | 2041 MARTIN LUTHER KING JR AVE SE SUITE: LL-2
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City | WASHINGTON
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State | DC
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Zip | 20020-7024
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Country | US
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Telephone | 202-678-2693
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Fax | 202-610-2699
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Provider Business Mailing Address
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Address Line | 9120 VENDOM DRIVE
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City | BETHESDA
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State | MD
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Zip | 20817-4021
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Country | US
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Telephone | 202-678-2693
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Fax | 202-610-2699
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD12382
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License Number State | DC
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