Kang, Edward Park

Kang, Edward Park is an individual health care provider with primary practice located at 460 Northside Cherokee Blvd Ste 100 , Canton GA 30115-8017. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Kang, Edward Park can be contacted via phone (770) 292-3490.

Contact Information

Primary practice address
460 Northside Cherokee Blvd Ste 100 Canton GA 30115-8017
Phone: (770) 292-3490
Fax: (770) 721-5615
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 54147 Minnesota
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 70309 Georgia
Allopathic & Osteopathic Physicians / Surgery 208600000X 4301086626 Michigan

Profile Details

NPI number 1154504082
LBN Legal business name Kang, Edward Park
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2007
Last updated Apr 27th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154504082 NPPES
Georgia MEDICAID 003135923B
Georgia MEDICAID 003135923A
Georgia MEDICAID 003135923D

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