Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 25MA04898900 | NJ |
N | 208600000X | Surgeon | 25MA04898900 | NJ |
Y | 2086S0127X | Trauma Surgeon | 25MA04898900 | NJ |
N | 2086S0129X | Vascular Surgeon | 25MA04898900 | NJ |
NPI | 1326013509 |
---|---|
Provider Name | Dr. Peter Thompson |
First Address | Camden, NJ 08103-1438 |
Second Address | Camden, NJ 08103-1438 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 29/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020054424 | RAILROAD MC (01) | NJ |
0683523000 | AMERIHEALTH (01) | NJ |
1167806 | HORIZON MERCY (01) | NJ |
14987 | UNIVERSITY HEALTH PLANS (01) | NJ |
200001299 | AETNA (01) | NJ |
200001299 | CIGNA (01) | NJ |
200001299 | UNITED HEALTHCARE (01) | NJ |
6031803 | (05) | NJ |
AT000006700 | AMERICHOICE (01) | NJ |
F71219 | (02) | NJ |
MA04898900 | STATE LICENSE (01) | NJ |