Provider Demographics
NPI:1982638052
Name:HUNT, PETER WHITTEMORE (DC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:WHITTEMORE
Last Name:HUNT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018
Mailing Address - Country:US
Mailing Address - Phone:484-895-0107
Mailing Address - Fax:484-895-0109
Practice Address - Street 1:215 W BROAD STREET
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018
Practice Address - Country:US
Practice Address - Phone:484-895-0107
Practice Address - Fax:484-895-0109
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006567L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011939420001Medicaid
PA3710183OtherAETNA
PAHU1671083OtherHIGHMARK BCBS
PA1038134OtherASHN
PA11372693OtherCAQH
PA50047218OtherCAPITAL BCBS
PA1038134OtherASHN
PA003887RY7Medicare ID - Type Unspecified