MEDICARE: DAVID B PEISNER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VM0101X	Maternal & Fetal Medicine Physician	MD433961	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MD433961	OTHER	PA	STATE MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124095443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID B PEISNER MD

Provider Business Mailing Address
First Line	:	869 BEAVER DRIVE
Second Line	:
City	:	DUBOIS
State	:	PA
Zip	:	15801
Country	:	US
Telephone Number	:	814-371-6501
Fax Number	:	814-371-6504

Provider Business Practice Location Address
First Line	:	869 BEAVER DRIVE
Second Line	:
City	:	DUBOIS
State	:	PA
Zip	:	15801
Country	:	US
Telephone Number	:	814-371-6501
Fax Number	:	814-371-6504

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2006
Last Update Date	:	05/23/2020

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Directions to “ DAVID B PEISNER MD” Practice Location

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