Provider Demographics
NPI:1477942209
Name:KWEON, HYEON CHEOL (PHAMD)
Entity Type:Individual
Prefix:DR
First Name:HYEON
Middle Name:CHEOL
Last Name:KWEON
Suffix:
Gender:M
Credentials:PHAMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5511A CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4106
Mailing Address - Country:US
Mailing Address - Phone:770-671-9424
Mailing Address - Fax:770-671-9516
Practice Address - Street 1:5511A CHAMBLEE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4106
Practice Address - Country:US
Practice Address - Phone:770-671-9424
Practice Address - Fax:770-671-9516
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60385218183500000X
GARPH033587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist