Individual
DR. PETER KEN KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1952A PULASKI HWY, EDGEWOOD, MD 21040-1617
(410) 538-7000
(410) 679-7825
Mailing address
3 NASHUA CT, SUITE H, BALTIMORE, MD 21221-3133
(410) 933-5678
(410) 933-4835
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
D0012744
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1795473
CAQH
MD
01
—
600852
CAREFIRST
MD
Enumeration date
07/28/2006
Last updated
07/08/2007
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