Provider Demographics
NPI:1952495954
Name:KWON, OKI (MD)
Entity Type:Individual
Prefix:
First Name:OKI
Middle Name:
Last Name:KWON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10313 GEORGIA AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5006
Mailing Address - Country:US
Mailing Address - Phone:301-681-9781
Mailing Address - Fax:301-681-9780
Practice Address - Street 1:10313 GEORGIA AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5006
Practice Address - Country:US
Practice Address - Phone:301-681-9781
Practice Address - Fax:301-681-9780
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD30927207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC70260001OtherBC BS OF NCA
MD05497011OtherUNITED MID ATLANTIC
MD101047OtherUNITED HEALTHCARE
MD361081100Medicaid
DC00652OtherG.W.U. HEALTH PLAN
MD10201150OtherCIGNA HEALTH CARE
MD80132OtherALLIANCE PPO
MD4131819OtherAETNA PPO
MD024678OtherAETNA HMO
MD30927OtherWASHINGTON HEALTHNET
MD80132OtherMDIPA AND OPTIMUM CHOICE
MD9212OtherKAISER
MD025903OtherHEALTH KEEPERS
MD26667OtherEHP HEALTHCARE
MD5369OtherCAREFIRST BC BS OF MD
MD30927OtherWASHINGTON HEALTHNET