Provider Demographics
NPI:1366563249
Name:KWON, ELENA HN (DO)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:HN
Last Name:KWON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:H
Other - Last Name:JEHAN-ABDUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:267 HARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-3027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17197 N LAUREL PARK DR STE 107
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-7910
Practice Address - Country:US
Practice Address - Phone:734-338-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017122207P00000X
OH34.016026207P00000X
WV3873207P00000X
GA88710207P00000X
MDH86275207P00000X
KY04515207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine