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General NPI Number Information
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NPI Number | 1881671238
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Entity Type | Individual
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Provider Name | MICHAEL B PEYSER MD
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 1575 WASHINGTON ST
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City | WATERTOWN
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State | NY
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Zip | 13601-9371
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Country | US
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Telephone | 315-788-2805
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Fax | 315-779-5066
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Provider Business Mailing Address
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Address Line | 830 WASHINGTON ST
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City | WATERTOWN
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State | NY
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Zip | 13601-4034
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Country | US
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Telephone | 315-786-7501
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Fax | 315-779-5306
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101056084
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 0101056084
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 217155
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License Number State | NY
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