Provider Demographics
NPI:1871566877
Name:HWANG, STEVE K (MD)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:K
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 962650
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-6926
Mailing Address - Country:US
Mailing Address - Phone:404-669-9080
Mailing Address - Fax:404-669-9059
Practice Address - Street 1:1136 CLEVELAND AVE STE 408
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-3618
Practice Address - Country:US
Practice Address - Phone:404-669-9080
Practice Address - Fax:404-669-9059
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021723208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000200846AMedicaid
GA000200846AMedicaid