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NPI 1790737666

NPI 1790737666 : PETER S OH DO : EPHRATA, PA

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General NPI Number Information
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    NPI Number           |    1790737666
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    Entity Type          |    Individual 
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    Provider Name        |    PETER S OH DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/17/2006
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    Last Update Date     |    10/04/2024
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Provider Practice Location Address
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    Address Line         |    4131A OREGON PIKE 
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    City                 |    EPHRATA
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    State                |    PA
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    Zip                  |    17522-9550
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    Country              |    US
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    Telephone            |    717-859-1123
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    Fax                  |    717-859-2898
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Provider Business Mailing Address
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    Address Line         |    601 MEMORY LN 
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    City                 |    YORK
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    State                |    PA
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    Zip                  |    17402-2231
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    Country              |    US
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    Telephone            |    717-851-1405
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    OS006535L
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    License Number State |    PA
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