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General NPI Number Information
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NPI Number | 1376077693
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Entity Type | Individual
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Provider Name | COLIN PETERS JR. D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 318 CHRIS GAUPP DR
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City | GALLOWAY
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State | NJ
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Zip | 08205-4460
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Country | US
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Telephone | 609-748-7300
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Fax | 609-748-7919
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Provider Business Mailing Address
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Address Line | PO BOX 13579
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City | READING
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State | PA
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Zip | 19612-3579
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MB12188500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OT017582
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 25MB12188500
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 25MB12188500
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License Number State | NJ
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