Provider Demographics
NPI:1609834563
Name:PETERS, BARBARA T (DO)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:T
Last Name:PETERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 BAKER AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2129
Mailing Address - Country:US
Mailing Address - Phone:978-287-9350
Mailing Address - Fax:978-287-9421
Practice Address - Street 1:330 BAKER AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2129
Practice Address - Country:US
Practice Address - Phone:978-287-9350
Practice Address - Fax:978-287-9421
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77219207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3109895Medicaid
MA18119OtherHARVARD PILGRIM
MA4324090OtherAETNA
MAJ13813OtherBLUE CROSS
MA6761777-002OtherCIGNA
MA0016164OtherNEIGHBORHOOD HEALTH
MA760208OtherTUFTS
MA760208OtherTUFTS
MAF43501Medicare UPIN