MEDICARE: MINYOUNG KANG MD

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	207R00000X	Internal Medicine Physician	206038	CA
2	207R00000X	Internal Medicine Physician	T4400	TX

General Provider Information

NPI Number	:	1639639891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINYOUNG KANG MD

Provider Business Mailing Address
First Line	:	DEPT OF MEDICINE HSC LEVEL 16 SUNY STONY BROOK HOSPITAL
Second Line	:
City	:	STONY BROOK
State	:	NY
Zip	:	11794-0001
Country	:	US
Telephone Number	:	631-444-2058
Fax Number	:	631-444-2493

Provider Business Practice Location Address
First Line	:	3500 W WHEATLAND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3460
Country	:	US
Telephone Number	:	682-552-3065
Fax Number	:

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

Provider Enumeration Date	:	03/23/2019
Last Update Date	:	01/07/2026

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Directions to “ MINYOUNG KANG MD” Practice Location

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