Provider Demographics
NPI:1619375474
Name:PETERS, NORMAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:DAVID
Last Name:PETERS
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 1:30 WINSOR RD
Mailing Address - Street 2:
Mailing Address - City:N SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1172
Mailing Address - Country:US
Mailing Address - Phone:401-934-1832
Mailing Address - Fax:
Practice Address - Street 1:30 WINSOR RD
Practice Address - Street 2:
Practice Address - City:N SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1172
Practice Address - Country:US
Practice Address - Phone:401-934-1832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI5272207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery