Provider Demographics
NPI:1285912857
Name:KWON, CAROLINE (MD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:KWON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3930 WALNUT ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4738
Mailing Address - Country:US
Mailing Address - Phone:703-246-9246
Mailing Address - Fax:703-246-9257
Practice Address - Street 1:3930 WALNUT ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4738
Practice Address - Country:US
Practice Address - Phone:703-246-9246
Practice Address - Fax:703-246-9257
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101259942207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology