Joe, Sungnam
Joe, Sungnam is an sole proprietor health care provider with primary practice located at 2226 Hualapai Mountain Rd , Kingman AZ 86401-8374. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Joe, Sungnam can be contacted via phone (928) 681-8530.Contact Information
Primary practice address
2226 Hualapai Mountain Rd
Kingman AZ 86401-8374
Phone: (928) 681-8530
Fax: (928) 681-8714
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 24593 | Arizona |
Profile Details
NPI number | 1376538389 |
---|---|
LBN Legal business name | Joe, Sungnam |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 15th, 2005 |
Last updated | Mar 9th, 2024 - about 9 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1376538389 | NPPES |
Arizona | Other | 24593 | LICENSE |
Arizona | MEDICAID | 363151 | LICENSE |
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