Provider Demographics
NPI:1104977420
Name:KWAN, GENE F (MD)
Entity type:Individual
Prefix:
First Name:GENE
Middle Name:F
Last Name:KWAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:732 HARRISON AVE, FL 3
Practice Address - Street 2:PRESTON BLDG
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2526
Practice Address - Country:US
Practice Address - Phone:617-638-7490
Practice Address - Fax:617-414-8742
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2024-04-10
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Provider Licenses
StateLicense IDTaxonomies
MA238206207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3107502Medicaid
MA110084094AMedicaid