Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 0102202174 | VA |
Y | 207RH0003X | Hematology & Oncology | 2017-02337 | NC |
NPI | 1043419096 |
---|---|
Provider Name | Dr. Jong Wook An |
First Address | Morrisville, NC 27560-5491 |
Second Address | Rocky Mount, NC 27804-2237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2007 |
Last Update Date | 10/02/2021 |