Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jaeon Kwak

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1639708696

Jaeon Kwak is a Student in an Organized Health Care Education/Training Program in Canton, Ohio. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2020
Specialties on file
2

Practice location Address checks out

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone: (330) 493-4443
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 0101277245 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1639708696
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 2, 2020
Last updated in NPPESJanuary 5, 2024
Certification dateJanuary 5, 2024
Mailing address2301 Erwin Rd, Durham, NC 27705-4699

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