Individual
PETER S VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9300 E 29TH ST N, SUITE 205, WICHITA, KS 67226-2182
(316) 219-8299
Mailing address
9300 E 29TH ST N, SUITE 205, WICHITA, KS 67226-2182
(316) 219-8299
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
APPLIED FOR TEMP
KS
363AS0400X
Surgical Physician Assistant
Primary
T-00858
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-00858
STATE LICENSE #
KS
Enumeration date
08/01/2006
Last updated
07/08/2007
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