Provider Demographics
NPI:1497742183
Name:DEGREEN, H PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:PETER
Last Name:DEGREEN
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:PO BOX 10396
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17605-0396
Mailing Address - Country:US
Mailing Address - Phone:717-291-1313
Mailing Address - Fax:717-291-6866
Practice Address - Street 1:1858 CHARTER LN
Practice Address - Street 2:STE 202
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17605-0396
Practice Address - Country:US
Practice Address - Phone:717-291-1313
Practice Address - Fax:717-291-6866
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023509E207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000763116Medicaid
B39997Medicare UPIN
PA152583Medicare PIN