Provider Demographics
NPI:1326740101
Name:KWOK, STEVEN
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:KWOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 THUNDER GULCH PASS
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-5444
Mailing Address - Country:US
Mailing Address - Phone:678-650-9966
Mailing Address - Fax:
Practice Address - Street 1:1625 THUNDER GULCH PASS
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-5444
Practice Address - Country:US
Practice Address - Phone:678-650-9966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH03172183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist