Provider Demographics
NPI:1720248289
Name:PELEG, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:PELEG
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 1:159 INTERSTATE PKWY
Mailing Address - Street 2:WOMEN'S HEALTH SERVICES
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-1013
Mailing Address - Country:US
Mailing Address - Phone:814-362-8480
Mailing Address - Fax:
Practice Address - Street 1:159 INTERSTATE PKWY
Practice Address - Street 2:WOMEN'S HEALTH SERVICES
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-1013
Practice Address - Country:US
Practice Address - Phone:814-362-8480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD22825207V00000X
PAMD432865207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD432865OtherMEDICAL LICENSE