Provider Demographics
NPI:1144455296
Name:KANG, PETER Y (DO)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:Y
Last Name:KANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:7 OAK HILL TER STE 218
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8996
Mailing Address - Country:US
Mailing Address - Phone:207-303-0022
Mailing Address - Fax:207-303-0023
Practice Address - Street 1:7 OAK HILL TER STE 218
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074
Practice Address - Country:US
Practice Address - Phone:207-303-0022
Practice Address - Fax:207-303-0023
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEDO24702084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry