Provider Demographics
NPI:1538200712
Name:KUNESH-PART, KRISTINE A (MD)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:A
Last Name:KUNESH-PART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:A
Other - Last Name:KUNESH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2601 FAR HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-1634
Mailing Address - Country:US
Mailing Address - Phone:937-298-1703
Mailing Address - Fax:937-298-6344
Practice Address - Street 1:2601 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45419-1634
Practice Address - Country:US
Practice Address - Phone:937-298-1703
Practice Address - Fax:937-298-6344
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049142207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0820065OtherUNITED HEALTH CARE
1369116OtherUMWA
000000006869OtherANTHEM
OH0540016Medicaid
1369116OtherUMWA
OH0593581Medicare PIN