Provider Demographics
NPI:1598046849
Name:KUOCH, KRASNA SENG (DN, PMD (IP) DEM)
Entity Type:Individual
Prefix:
First Name:KRASNA
Middle Name:SENG
Last Name:KUOCH
Suffix:
Gender:M
Credentials:DN, PMD (IP) DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 BUFORD HWY NE
Mailing Address - Street 2:SUITE A120
Mailing Address - City:DORAVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30340-1153
Mailing Address - Country:US
Mailing Address - Phone:770-986-9338
Mailing Address - Fax:770-986-9337
Practice Address - Street 1:5150 BUFORD HWY NE
Practice Address - Street 2:SUITE A120
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30340-1153
Practice Address - Country:US
Practice Address - Phone:770-597-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181.000330172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath