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Individual
MR. SOTHEA PETER SAING
Active
Individual
MR. SOTHEA PETER SAING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
19176
SC
363LF0000X
Family Nurse Practitioner
Primary
SP018152
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034843400001
—
PA
05
—
1034843400002
—
PA
01
—
635617KKU
MEDICARE
PA
01
—
SP018152
CRNP LICENSE
PA
Enumeration date
02/25/2015
Last updated
09/26/2019
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