MEDICARE: DR. MEETA DEVENDRA PEER M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	MD037566L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154328136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEETA DEVENDRA PEER M.D.

Provider Business Mailing Address
First Line	:	9701 BUSTLETON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-3201
Country	:	US
Telephone Number	:	215-677-3000
Fax Number	:	215-677-9919

Provider Business Practice Location Address
First Line	:	9701 BUSTLETON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-3201
Country	:	US
Telephone Number	:	215-677-3000
Fax Number	:	215-677-9919

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	11/03/2016

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