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NPI Code Detail

MEDICARE: DR. HYUK SANG KWON

MEDICARE:  DR. HYUK SANG  KWON
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
11223P0300XPeriodontics6001028WI

General Provider Information

NPI Number : 1255726170
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HYUK SANG KWON
Provider Business Mailing Address
First Line : 1621 W WELLS ST
Second Line : APT #409
City : MILWAUKEE
State : WI
Zip : 53233-3204
Country : US
Telephone Number : 414-377-2371
Fax Number :
Provider Business Practice Location Address
First Line : 840 W JUNEAU AVE APT 122
Second Line :
City : MILWAUKEE
State : WI
Zip : 53233-1450
Country : US
Telephone Number : 402-517-2220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2015
Last Update Date : 08/11/2023

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Directions to “ DR. HYUK SANG KWON ” Practice Location

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