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General NPI Number Information
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NPI Number | 1013998186
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Entity Type | Individual
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Provider Name | KENTEN PEY-KUEN WANG D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 101 ELM AVE SE
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City | ROANOKE
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State | VA
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Zip | 24013-2222
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Country | US
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Telephone | 540-985-9992
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Fax |
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 1006
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City | ROANOKE
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State | VA
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Zip | 24011-1713
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 036162106
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OP61657882
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 6909
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 20A7684
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 0102206314
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License Number State | VA
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