Individual
MATTHEW KONGKATONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0816
(434) 924-2231
(434) 924-9295
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22908-0816
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101262361
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
03/26/2014
Last updated
09/30/2020
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