MEDICARE: DR. PHILBERT KUO D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	0103001032	VA

General Provider Information

NPI Number	:	1487622445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILBERT KUO D.P.M.

Provider Business Mailing Address
First Line	:	3212 CHURCHLAND BLVD
Second Line	:	SUITE 10
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-5262
Country	:	US
Telephone Number	:	757-483-4126
Fax Number	:	757-483-6443

Provider Business Practice Location Address
First Line	:	3212 CHURCHLAND BLVD
Second Line	:	SUITE 10
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-5262
Country	:	US
Telephone Number	:	757-483-4126
Fax Number	:	757-483-6443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	07/20/2009

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