Provider Demographics
NPI:1851999882
Name:INTEGRATIVE WELLNESS PARTNERS, INC
Entity Type:Organization
Organization Name:INTEGRATIVE WELLNESS PARTNERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEUNG
Authorized Official - Middle Name:WON
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-912-2400
Mailing Address - Street 1:603 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NC
Mailing Address - Zip Code:28398-2104
Mailing Address - Country:US
Mailing Address - Phone:910-659-1088
Mailing Address - Fax:888-446-3125
Practice Address - Street 1:7 BERKSHIRE RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4748
Practice Address - Country:US
Practice Address - Phone:919-912-2400
Practice Address - Fax:919-912-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty