Provider Demographics
NPI:1568988350
Name:UNG, KEVIN HAYES (DPT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:HAYES
Last Name:UNG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 79831
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0831
Mailing Address - Country:US
Mailing Address - Phone:301-657-9876
Mailing Address - Fax:301-657-8240
Practice Address - Street 1:5530 WISCONSIN AVE STE 1650
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4323
Practice Address - Country:US
Practice Address - Phone:301-986-9100
Practice Address - Fax:301-657-8229
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT872152225100000X
MD26608225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist