Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD433961 | PA |
NPI | 1124095443 |
---|---|
Provider Name | David B Peisner |
First Address | Dubois, PA 15801 |
Second Address | Dubois, PA 15801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2006 |
Last Update Date | 23/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102114433 | (05) | PA |
1021144330001 | (05) | PA |
A60312 | (02) | PA |
MD433961 | STATE MEDICAL LICENSE (01) | PA |