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Individual

PETER M KIGONYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 HOSPITAL DR, GALAX, VA 24333-2227
(276) 236-0065
Mailing address
PO BOX 1337, GALAX, VA 24333-1337
(276) 236-0065

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101240698
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C04388
MEDICARE GROUP #
Enumeration date
10/06/2006
Last updated
02/12/2008
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