Provider Demographics
NPI:1982644001
Name:EVERETT, PETER JANSEN (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JANSEN
Last Name:EVERETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:193 LOCUST ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2056
Mailing Address - Country:US
Mailing Address - Phone:413-584-8700
Mailing Address - Fax:413-584-1714
Practice Address - Street 1:193 LOCUST ST
Practice Address - Street 2:SUITE 2
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2056
Practice Address - Country:US
Practice Address - Phone:413-584-8700
Practice Address - Fax:413-584-1714
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2012-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA249766208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics