MEDICARE: PETER H MASON DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	36-00-2819M	OH
2	213ES0103X	Foot & Ankle Surgery Podiatrist	PO3344	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003800525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER H MASON DPM

Provider Business Mailing Address
First Line	:	1632 STAFFORD SPRINGS PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-6033
Country	:	US
Telephone Number	:	937-608-0396
Fax Number	:

Provider Business Practice Location Address
First Line	:	1632 STAFFORD SPRINGS PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-6033
Country	:	US
Telephone Number	:	937-608-0396
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	02/18/2016

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Directions to “ PETER H MASON DPM” Practice Location

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