Provider Demographics
NPI:1306815576
Name:AWH, MARK HYUNCHOL (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:HYUNCHOL
Last Name:AWH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:308 NORTH PETERS ROAD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922
Mailing Address - Country:US
Mailing Address - Phone:865-694-0062
Mailing Address - Fax:865-694-7907
Practice Address - Street 1:8 CADILLAC DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027
Practice Address - Country:US
Practice Address - Phone:615-376-7500
Practice Address - Fax:615-376-7575
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2013-03-26
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Provider Licenses
StateLicense IDTaxonomies
TNMD0243922085R0202X
IL360812762085R0202X
KY290162085R0202X
NMT200204552085R0202X
FLME841902085R0202X
MS120852085R0202X
GA0521402085R0202X
AL000249892085R0202X
OH821852085R0202X
CO415862085R0202X
AZ316562085R0202X
TXTELEMED2085R0202X
NJ25MA076704002085R0202X
LA15284R2085R0202X
VA01012357862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3076196Medicaid
TN3076196Medicare PIN
F18514Medicare UPIN