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General NPI Number Information
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NPI Number | 1568787414
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Entity Type | Organization
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Legal Business Name | DR. PETER SEBASTIAN D.O. PA
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 32071 BEAVER RUN DR STE B
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City | SALISBURY
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State | MD
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Zip | 21804-1773
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Country | US
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Telephone | 410-341-6520
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Fax | 410-341-6526
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Provider Business Mailing Address
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Address Line | PO BOX 1859
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City | SALISBURY
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State | MD
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Zip | 21802-1859
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Country | US
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Telephone | 410-341-6520
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Fax | 410-341-6526
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KATHY JO THOMAS
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Credential |
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Telephone | 410-341-6520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | H0029243
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License Number State | MD
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