Healthcare Provider Details

I. General information

NPI: 1134588973
Provider Name (Legal Business Name): ANDREW KUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2016
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WALNUT ST STE 205
LEMOYNE PA
17043-1168
US

IV. Provider business mailing address

300 TUSKEGEE BLVD
DOVER AFB DE
19902-5003
US

V. Phone/Fax

Practice location:
  • Phone: 717-988-0090
  • Fax: 717-221-5320
Mailing address:
  • Phone: 302-730-4633
  • Fax: 302-677-2006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD495080
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: