Provider Demographics
NPI:1710900428
Name:BEVINS, PETER ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ALEXANDER
Last Name:BEVINS
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 1:13 WADSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1953
Mailing Address - Country:US
Mailing Address - Phone:781-828-3533
Mailing Address - Fax:781-828-2471
Practice Address - Street 1:140 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6700
Practice Address - Country:US
Practice Address - Phone:978-374-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51563207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0007183OtherNEIGHBORHOOD HEALTH
MA601512OtherHARVARD PILGRIM HEALTH
MAJ04095OtherBLUE CROSS & BLUE SHIELD
MA051563OtherTUFTS HEALTH PLAN
MA6189113Medicaid
MA0007183OtherNEIGHBORHOOD HEALTH
MA601512OtherHARVARD PILGRIM HEALTH