Provider Demographics
NPI:1790868412
Name:KUONG, ALLAN PHILIP (DO)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:PHILIP
Last Name:KUONG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 BOSTON TPKE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-5224
Mailing Address - Country:US
Mailing Address - Phone:508-831-4080
Mailing Address - Fax:
Practice Address - Street 1:222 BOSTON TPKE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-5224
Practice Address - Country:US
Practice Address - Phone:508-831-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80098207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME010453642OtherMEDNET
ME2533222OtherAETNA
ME282200099Medicaid
ME104384OtherCIGNA
ME039480OtherANTHEM
ME010453642OtherGREATWEST/ONE HEALTH
ME930103617OtherRR MEDICARE
MEF88000OtherHARVARD PILGRIM
MEF88000Medicare UPIN