Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2006-01944 | NC |
NPI | 1003836321 |
---|---|
Provider Name | Dr. John Sunghoon Won |
First Address | Raleigh, NC 27617 |
Second Address | Raleigh, NC 27617-2046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 15/08/2017 |