Provider Demographics
NPI:1073577995
Name:PEFFER, C. BRIAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:C.
Middle Name:BRIAN
Last Name:PEFFER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 POPLAR CHURCH RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2250
Mailing Address - Country:US
Mailing Address - Phone:717-763-4693
Mailing Address - Fax:717-763-4694
Practice Address - Street 1:890 POPLAR CHURCH RD
Practice Address - Street 2:SUITE 301
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2250
Practice Address - Country:US
Practice Address - Phone:717-763-4693
Practice Address - Fax:717-763-4694
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001923-L213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01122801OtherCAPITAL BLUE CROSS
PA093143OtherHIGHMARK BLUE SHIELD
PA01122801OtherCAPITAL BLUE CROSS