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General NPI Number Information
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NPI Number | 1568605632
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Entity Type | Organization
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Legal Business Name | PHILBERT H. KUO, D.P.M.
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Dates
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Enumeration Date | 04/19/2009
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 3212 CHURCHLAND BLVD SUITE 10
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5262
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Country | US
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Telephone | 757-483-4126
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Fax | 757-483-6443
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Provider Business Mailing Address
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Address Line | 3212 CHURCHLAND BLVD SUITE 10
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5262
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Country | US
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Telephone | 757-483-4126
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Fax | 757-483-6443
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Authorized Official
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Title or Position | OWNER
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Name | PHILBERT KUO
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Credential | D.P.M.
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Telephone | 757-483-4126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 0103001032
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License Number State | VA
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