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Individual

DR. PETER KUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
625 9TH AVE STE 210, LONGVIEW, WA 98632-2465
(360) 501-3400
(360) 423-6862
Mailing address
625 9TH AVE STE 210, LONGVIEW, WA 98632-2465
(360) 501-3400
(360) 423-6862

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A91539
CA
207X00000X
Orthopaedic Surgery Physician
Primary
MD60091872
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0249916
DEPT OF LABOR & INDUSTRIES
WA
01
500608782
MEDICAID
OR
05
8546244
WA
Enumeration date
03/08/2007
Last updated
07/14/2010
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