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General NPI Number Information
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NPI Number | 1780885491
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Entity Type | Individual
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Provider Name | EUN JI KWON M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 1 CRANBERRY HL STE 105
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City | LEXINGTON
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State | MA
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Zip | 02421-7397
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Country | US
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Telephone | 800-325-7284
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Fax | 205-579-9387
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Provider Business Mailing Address
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Address Line | 1 CRANBERRY HL STE 105
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City | LEXINGTON
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State | MA
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Zip | 02421-7397
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Country | US
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Telephone | 800-325-7284
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Fax | 205-579-9387
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 69371
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 251783
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 1017784
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 251783
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 69371
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 1017784
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License Number State | MA
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