Kwon, Mary

Kwon, Mary is an individual health care provider with primary practice located at 2550 University Ave W Suite 189S, Saint Paul MN 55114-1052. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as her primary health care specialty. Kwon, Mary can be contacted via phone (651) 332-7474.

Contact Information

Primary practice address
2550 University Ave W Suite 189S Saint Paul MN 55114-1052
Phone: (651) 332-7474
Fax: (651) 332-7475
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 27500 Minnesota

Profile Details

NPI number 1790797645
LBN Legal business name Kwon, Mary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Jul 8th, 2007 - about 17 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790797645 NPPES
Minnesota Other 376001 PREFERRED ONE
Minnesota Other 23-08420 PREFERRED ONE
Minnesota Other 09128KW PREFERRED ONE
Minnesota MEDICAID 357573000 PREFERRED ONE

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