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General NPI Number Information
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NPI Number | 1962897181
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Entity Type | Individual
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Provider Name | SOOK HWANG
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Gender | Female
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 5839 W MAPLE RD STE 109
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-2278
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Country | US
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Telephone | 248-855-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 21050 W 14 MILE RD
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48301-4104
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Country | US
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Telephone | 248-842-4646
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Fax | 630-495-1770
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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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 | 4301502319
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License Number State | MI
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