Provider Demographics
NPI:1295736189
Name:KUMMANT, PETER K (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:K
Last Name:KUMMANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST
Mailing Address - Street 2:STE 800
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1434
Mailing Address - Country:US
Mailing Address - Phone:606-330-7818
Mailing Address - Fax:606-330-7825
Practice Address - Street 1:12579 MAIN STREET
Practice Address - Street 2:STE 101
Practice Address - City:MARTIN
Practice Address - State:KY
Practice Address - Zip Code:41649-0910
Practice Address - Country:US
Practice Address - Phone:606-285-0681
Practice Address - Fax:606-285-9843
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA034039-E208600000X
KY46983208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000678684OtherSECURITY BLUE
020048938OtherUNITED HEALTHCARE
219141OtherUPMC FOR YOU
PACI6850OtherMEDICARE RAILROAD
KYK146780OtherMEDICARE
123225OtherTHREE RIVERS HEALTH PLAN
2588679OtherAETNA
PA678684OtherHIGHMARK BC/BS
1517401OtherGATEWAY HEALTH PLAN
PA678684OtherKEYSTONE HEALTH PLAN WEST
PA1911411OtherFIRST HEALTH
251828837OtherDEVON HEALTH PLAN
PA0012567360003Medicaid
116818OtherANTHEM BC/BS
219141OtherUPMC
5007868-001OtherCIGNA
KY7100312840Medicaid
PA0012567360003Medicaid