Healthcare Provider Details

I. General information

NPI: 1548377542
Provider Name (Legal Business Name): PETER A KUHL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 06/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2093 HEALTH DR SW STE 200
WYOMING MI
49519
US

IV. Provider business mailing address

1900 WEALTHY ST SE STE 150
GRAND RAPIDS MI
49506-2969
US

V. Phone/Fax

Practice location:
  • Phone: 616-459-3158
  • Fax: 616-819-2222
Mailing address:
  • Phone: 616-459-3158
  • Fax: 616-988-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301044003
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: