Provider Demographics
NPI:1205896644
Name:DEGNAN, PETER JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:JOSEPH
Last Name:DEGNAN
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 1:9 LOOKOUT PLACE DR
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1733
Mailing Address - Country:US
Mailing Address - Phone:603-770-0414
Mailing Address - Fax:603-516-4254
Practice Address - Street 1:302 NEWMARKET ST BLDG 255
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03803-2869
Practice Address - Country:US
Practice Address - Phone:603-430-2340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
NH8794207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171000000XOther Service ProvidersMilitary Health Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3075306Medicaid
ME1205896644Medicaid
NHE98738Medicare UPIN
NHRE240201Medicare PIN