Individual
DR. JOHN STEPHEN KUNDRAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PA
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M3432
ID
207W00000X
Ophthalmology Physician
MD00014874
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002460100
—
ID
01
—
1478601
MEDICAID
WA
Enumeration date
11/30/2006
Last updated
12/19/2012
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