Provider Demographics
NPI:1902899487
Name:KWEE, HIM GAN (MD)
Entity Type:Individual
Prefix:
First Name:HIM
Middle Name:GAN
Last Name:KWEE
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 1:100 SOUTH SECOND STREET
Mailing Address - Street 2:LABORATORY
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17105-8700
Mailing Address - Country:US
Mailing Address - Phone:717-652-6105
Mailing Address - Fax:717-652-2165
Practice Address - Street 1:111 SOUTH FRONT STREET
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-8700
Practice Address - Country:US
Practice Address - Phone:717-782-5640
Practice Address - Fax:717-782-5352
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019967E207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005495370001Medicaid
PA0005495370003Medicaid
PA024205G03Medicare PIN
B33491Medicare UPIN