MEDICARE: DR. DAVID S. KWON M.D.

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	207RC0000X	Cardiovascular Disease Physician	MD035647	DC

General Provider Information

NPI Number	:	1518136134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID S. KWON M.D.

Provider Business Mailing Address
First Line	:	4067 S FOUR MILE RUN DR
Second Line	:	#403
City	:	ARLINGTON
State	:	VA
Zip	:	22204-5611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4067 S FOUR MILE RUN DR
Second Line	:	#403
City	:	ARLINGTON
State	:	VA
Zip	:	22204-5611
Country	:	US
Telephone Number	:	202-877-2000
Fax Number	:

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

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	02/27/2008

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