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NPI Code Detail

MEDICARE: DR. PETER LEE KANG M.D.

MEDICARE: DR. PETER LEE KANG M.D.
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
1207P00000XEmergency Medicine Physician35.089566OH
2207P00000XEmergency Medicine PhysicianMD433950PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649479932
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER LEE KANG M.D.
Provider Business Mailing Address
First Line : 409 S 2ND ST STE 2F
Second Line :
City : HARRISBURG
State : PA
Zip : 17104-1612
Country : US
Telephone Number : 717-231-8919
Fax Number :
Provider Business Practice Location Address
First Line : 6481 CARLISLE PIKE
Second Line :
City : MECHANICSBURG
State : PA
Zip : 17050-2377
Country : US
Telephone Number : 717-796-9355
Fax Number : 717-620-8093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2007
Last Update Date : 01/19/2021

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