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General NPI Number Information
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NPI Number | 1801868856
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Entity Type | Individual
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Provider Name | PETER W JUNG MD
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 216 MOORE RD
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City | KING
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State | NC
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Zip | 27021-8703
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Country | US
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Telephone | 336-983-4346
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 FRONTIS PLAZA BLVD STE 200 ATTN FORSYTH MEDICAL GROUP
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City | WINSTON SALEM
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State | NC
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Zip | 27103-5616
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Country | US
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Telephone | 336-277-2436
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9401426
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License Number State | NC
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