Provider Demographics
NPI:1013010271
Name:TANZER, PETER P (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:P
Last Name:TANZER
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 1:300 HALKET ST 1700
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3108
Mailing Address - Country:US
Mailing Address - Phone:412-692-2992
Mailing Address - Fax:412-687-5611
Practice Address - Street 1:300 HALKET ST 1700
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3108
Practice Address - Country:US
Practice Address - Phone:412-692-2992
Practice Address - Fax:412-687-5611
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025088E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009001900003Medicaid
PA101014FN3Medicare PIN
PAB36423Medicare UPIN