| Doctor Name: | DR. PETER STEPHEN KONCHAK |
| NPI Number: | 1669452025 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | MB06099100 |
| Business Practice Address: | 100 Kings Way E Suite # B5 Sewell, NJ - 080802237 |
| Business Phone Number: | 8565891414 |
| Business Fax Number: | 8565897193 |
| Mailing Address: | Po Box 635, BELLMAWR |
| State: | NJ |
| Postal Code: | 080990635 |
| Phone Number: | 8567705772 |
| Fax Number: | 8565662797 |
| NPI Enumeration Date: | 01/20/2006 |
| NPI Last Update Date: | 07/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | MB06099100 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |