Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD058926L | PA |
N | 111NI0900X | Internist | MD058926L | PA |
N | 208000000X | Pediatrician | MD058926L | PA |
Y | 2080A0000X | Adolescent Medicine | MD058926L | PA |
NPI | 1104834845 |
---|---|
Provider Name | Nadja G Peter |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Philadelphia, PA 19104-3368 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 15/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001903150 | (05) | PA |
8839701 | (05) | NJ |
H73648 | (02) |