Provider Demographics
NPI:1346236890
Name:WON, KWAN H (MD)
Entity Type:Individual
Prefix:DR
First Name:KWAN
Middle Name:H
Last Name:WON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3810 TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4336
Mailing Address - Country:US
Mailing Address - Phone:717-761-8877
Mailing Address - Fax:717-761-4994
Practice Address - Street 1:3810 TRINDLE RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4336
Practice Address - Country:US
Practice Address - Phone:717-761-8877
Practice Address - Fax:717-761-4994
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031837L207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
01122601OtherCAPITAL BLUE CROSS
11964OtherHEALTH ASSURANCE
0990399OtherKEYSTONE HEALTH PLAN
PAW02664OtherBLUE SHIELD AND FEDERAL
2220162OtherAETNA
11964OtherHEALTH AMERICA
1290415001OtherCIGNA
POO2905OtherMAIL HANDLERS
2220162OtherAETNA
C26062Medicare UPIN