Provider Demographics
NPI:1730108150
Name:DUCH, PETER M (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:M
Last Name:DUCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:167 MAIN ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2771
Mailing Address - Country:US
Mailing Address - Phone:732-662-9845
Mailing Address - Fax:732-662-9848
Practice Address - Street 1:167 MAIN ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2771
Practice Address - Country:US
Practice Address - Phone:732-662-9845
Practice Address - Fax:732-662-9848
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05938400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0045390Medicaid
NJ051232Medicare PIN
NJF33815Medicare UPIN