Provider Demographics
NPI:1326013509
Name:THOMPSON, PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:THOMPSON
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 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-963-6888
Mailing Address - Fax:856-968-8499
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 411
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-342-3014
Practice Address - Fax:856-342-2817
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04898900208600000X, 2086S0127X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1167806OtherHORIZON MERCY
NJ6031803Medicaid
NJAT000006700OtherAMERICHOICE
NJ200001299OtherAETNA
NJ200001299OtherUNITED HEALTHCARE
NJMA04898900OtherSTATE LICENSE
NJ200001299OtherCIGNA
NJ14987OtherUNIVERSITY HEALTH PLANS
NJ020054424OtherRAILROAD MC
NJ0683523000OtherAMERIHEALTH
NJ6031803Medicaid
NJMA04898900OtherSTATE LICENSE