MEDICARE: SUNGSOO HWANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	17906	CA
2	171100000X	Acupuncturist	96255	WV

General Provider Information

NPI Number	:	1093279184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNGSOO HWANG

Provider Business Mailing Address
First Line	:	629 CONGRESS AVE
Second Line	:
City	:	STAR CITY
State	:	WV
Zip	:	26505-2019
Country	:	US
Telephone Number	:	681-209-3180
Fax Number	:

Provider Business Practice Location Address
First Line	:	629 CONGRESS AVE
Second Line	:
City	:	STAR CITY
State	:	WV
Zip	:	26505-2019
Country	:	US
Telephone Number	:	681-209-3180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2019
Last Update Date	:	10/26/2024

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Directions to “ SUNGSOO HWANG ” Practice Location

Language	Start Address	Practice Location

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