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Individual

PETER O. KWONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
225 CLEARFIELD AVE, VIRGINIA BEACH, VA 23462-1815
(757) 452-3480
(757) 452-3482
Mailing address
225 CLEARFIELD AVE, VIRGINIA BEACH, VA 23462-1815
(757) 452-3480
(757) 452-3482

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101232710
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007504284
VA
01
196919
ANTHEM BC/BS
01
245559
ANTHEM BC BS
VA
01
58060
SENTARA HEALTHCARE
VA
Enumeration date
01/09/2006
Last updated
11/27/2013
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