Healthcare Provider Details

I. General information

NPI: 1720248289
Provider Name (Legal Business Name): DAVID PELEG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 02/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 INTERSTATE PKWY WOMEN'S HEALTH SERVICES
BRADFORD PA
16701-1013
US

IV. Provider business mailing address

159 INTERSTATE PKWY WOMEN'S HEALTH SERVICES
BRADFORD PA
16701-1013
US

V. Phone/Fax

Practice location:
  • Phone: 814-362-8480
  • Fax:
Mailing address:
  • Phone: 814-362-8480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD22825
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD432865
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: