Provider Demographics
NPI:1801855531
Name:HOENIG, PETER A (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:A
Last Name:HOENIG
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 1:80 BEHARRELL ST # 80A
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-1739
Mailing Address - Country:US
Mailing Address - Phone:781-259-9292
Mailing Address - Fax:781-259-0747
Practice Address - Street 1:80 BEHARRELL ST # 80A
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-1739
Practice Address - Country:US
Practice Address - Phone:781-259-9292
Practice Address - Fax:781-259-0747
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59966207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9777563Medicaid
MAJ10543Medicare ID - Type Unspecified
MAE69468Medicare UPIN