Provider Demographics
NPI:1669677704
Name:SALTZMAN, PETER RONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:RONALD
Last Name:SALTZMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:99 SUMMER ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-1213
Mailing Address - Country:US
Mailing Address - Phone:617-587-1500
Mailing Address - Fax:617-587-1577
Practice Address - Street 1:231 MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4342
Practice Address - Country:US
Practice Address - Phone:508-586-2660
Practice Address - Fax:508-427-1505
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA304352084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB32082Medicare ID - Type Unspecified