Provider Demographics
NPI:1740222454
Name:UHM, KYUDONG PETER (MD)
Entity Type:Individual
Prefix:
First Name:KYUDONG
Middle Name:PETER
Last Name:UHM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:973-471-0981
Mailing Address - Fax:
Practice Address - Street 1:1117 US HIGHWAY 46
Practice Address - Street 2:SUITE 205
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2449
Practice Address - Country:US
Practice Address - Phone:973-471-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-02778207RH0003X
NJ25MA03065000207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C54156Medicare UPIN