Fong, Peter Edward
Fong, Peter Edward is an individual health care provider with primary practice located at 106 Allen St , Cumming GA 30040-2602. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Fong, Peter Edward can be contacted via phone (706) 549-8114.Contact Information
Primary practice address
106 Allen St
Cumming GA 30040-2602
Phone: (706) 549-8114
Fax: (706) 549-0151
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 056467 | Georgia |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207LA0401X | 56467 | Georgia |
Profile Details
| NPI number | 1154312312 |
|---|---|
| LBN Legal business name | Fong, Peter Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 4th, 2005 |
| Last updated | Apr 8th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154312312 | NPPES |
| Georgia | MEDICAID | 644068458T | |
| Georgia | MEDICAID | 644068458V | |
| Georgia | MEDICAID | 644068458X | |
| Georgia | MEDICAID | 644068458Y | |
| Georgia | MEDICAID | 644068458W | |
| Georgia | MEDICAID | 644068458U |
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