Provider Demographics
NPI:1881258549
Name:WOOD, PETER A (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:A
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:AUSTEN 2 SUITE 210
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2696
Mailing Address - Country:US
Mailing Address - Phone:617-724-4255
Mailing Address - Fax:617-726-3077
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:AUSTEN 2 SUITE 210
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-4255
Practice Address - Fax:617-726-3077
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA390200000X
MA2904712085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program