Provider Demographics
NPI:1568454296
Name:KWAN, HING L (DC)
Entity Type:Individual
Prefix:DR
First Name:HING
Middle Name:L
Last Name:KWAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 RADIO DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-8014
Mailing Address - Country:US
Mailing Address - Phone:336-249-6852
Mailing Address - Fax:336-249-6853
Practice Address - Street 1:674 RADIO DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-8014
Practice Address - Country:US
Practice Address - Phone:336-249-6852
Practice Address - Fax:336-249-6853
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1115111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08577OtherBCBS OF NC
NC8908577Medicaid
NC8908577Medicaid
NC244311Medicare ID - Type Unspecified