Organization
JOHN S KUNDRAT, MD PA
Active
Organization
JOHN S KUNDRAT, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN S KUNDRAT MD (PRESIDENT)
(208) 746-0458
Entity
Organization
Contact information
Practice address
3316 4TH ST, BLDG 3, LEWISTON, ID 83501-4405
(208) 746-0458
(208) 743-6020
Mailing address
3316 4TH ST, BLDG 3, LEWISTON, ID 83501-4405
(208) 746-0458
(208) 743-6020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M3432
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002460100
—
ID
05
—
1478601
—
WA
Enumeration date
01/07/2013
Last updated
01/07/2013
Update your record
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