Provider Demographics
NPI:1770655060
Name:PEIKIN, STEVEN R (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:PEIKIN
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 1:501 FELLOWSHIP RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3419
Mailing Address - Country:US
Mailing Address - Phone:856-963-3572
Mailing Address - Fax:856-338-9211
Practice Address - Street 1:501 FELLOWSHIP RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3419
Practice Address - Country:US
Practice Address - Phone:856-963-3572
Practice Address - Fax:856-338-9211
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA57880207RG0100X
PAMD017976207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
010001714 02OtherAMERICHOICE
1095892OtherCIGNA
1242540OtherUNITED HEALTH CARE
3644399OtherAETNA US-HEALTHCARE
727851OtherAMERIHEALTH PPO
727851OtherAMERIHEALTH PPO OF DEL
0565703000OtherAMERIHEAL,HMO, KEYSTONE, IBC
NJ5247209Medicaid
1020632OtherHORIZON NJ HEALTH
110084263OtherRAIL RAOD MEDICARE
13567OtherUNIVERSITY HEALTH
3K6139OtherHEALTH NET
DE1000034273Medicaid
P437739OtherOXFORD HEALTH PLAN
0123448OtherAETNA
G01766C01OtherDELEWARE MEDICARE
13567OtherUNIVERSITY HEALTH
3644399OtherAETNA US-HEALTHCARE
727851Medicare ID - Type Unspecified