Provider Demographics
NPI:1609869098
Name:DOSS, PETER S (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:S
Last Name:DOSS
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 1:1500 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001
Mailing Address - Country:US
Mailing Address - Phone:732-574-8999
Mailing Address - Fax:732-574-3488
Practice Address - Street 1:1500 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001
Practice Address - Country:US
Practice Address - Phone:732-574-8999
Practice Address - Fax:732-574-3488
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217412085R0202X, 2085R0204X
NJ25MA081572002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA217141OtherTUFTS HEALTH PLAN
MA2236722OtherFIRST HEALTH PLAN
MA5498907OtherFIRST HEALTH CCN
NH30204309Medicaid
MAP00197118OtherRAIL ROAD MEDICARE
MA58321OtherHEALTHY START
NH01Y007135MA01OtherNH BLUE SHIELD
MA3552171OtherAETNA/US HEALTHCARE
MA4904825OtherCIGNA
MA2015374Medicaid
MA90529OtherFALLON
MAJ26516OtherBLUE CROSS/BLUE SHIELD
MA58231OtherCHILDRENS MEDICAL PLAN
MA973009OtherNETWORK HEALTH PLAN
MAAA17288OtherHARVARD PILGRIM HEALTH CA
MA973009OtherNETWORK HEALTH PLAN
MA4904825OtherCIGNA
NH01Y007135MA01OtherNH BLUE SHIELD
MA58231OtherCHILDRENS MEDICAL PLAN