Provider Demographics
NPI:1508359746
Name:HARPER, PETER (DPM)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:HARPER
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 1:336 COLLEGE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2231
Mailing Address - Country:US
Mailing Address - Phone:724-744-1525
Mailing Address - Fax:
Practice Address - Street 1:336 COLLEGE AVE STE 106
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2231
Practice Address - Country:US
Practice Address - Phone:724-744-1525
Practice Address - Fax:724-774-0366
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006936213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty