Provider Demographics
NPI:1427002542
Name:PEET, DAVID C JR (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:PEET
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 789967
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-9967
Mailing Address - Country:US
Mailing Address - Phone:484-622-7395
Mailing Address - Fax:484-622-7399
Practice Address - Street 1:721 SKIPPACK PIKE
Practice Address - Street 2:SUITE 3
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1700
Practice Address - Country:US
Practice Address - Phone:215-793-0600
Practice Address - Fax:215-793-0759
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2018-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD016709E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0075837703OtherAMERICHOICE (UHC MA PLAN)
PA080134443OtherRRM
PA0002064OtherAETNA HMO
PA0047070000OtherIBC - PC/KHPE
PA10933962OtherCAQG ID#
PA140942OtherHIGHMARK BLUE SHIELD
PA0007583770003Medicaid
PA0047070000OtherAMERIHEALTH/INTERCOUNTY
PA1290772OtherCIGNA HMO/PPO
PA350803OtherPHCS
PA1065052OtherKEYSTONE MERCY
PA33022-MD016709EOtherHEALTH PARTNERS
PA4101142OtherAETNA PPO
PA2124447OtherALLIANCE/OPT CHC (MAMSI)
PA140942NFJMedicare ID - Type UnspecifiedHGSA