Provider Demographics
NPI:1154328136
Name:PEER, MEETA DEVENDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:MEETA
Middle Name:DEVENDRA
Last Name:PEER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 BUSTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-3201
Mailing Address - Country:US
Mailing Address - Phone:215-677-3000
Mailing Address - Fax:215-677-9919
Practice Address - Street 1:9701 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-3201
Practice Address - Country:US
Practice Address - Phone:215-677-3000
Practice Address - Fax:215-677-9919
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037566L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014250700002Medicaid
PAB34939Medicare UPIN
PA071494KS8Medicare ID - Type UnspecifiedPHYSICAL MEDICINE