MEDICARE: DR. PETER JAMES PEMA JR. DO

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	207R00000X	Internal Medicine Physician	34-001151	OH

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	:	1023358777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER JAMES PEMA JR. DO

Provider Business Mailing Address
First Line	:	4581 LANGPORT RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-4265
Country	:	US
Telephone Number	:	614-451-4235
Fax Number	:

Provider Business Practice Location Address
First Line	:	4581 LANGPORT RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-4265
Country	:	US
Telephone Number	:	614-451-4235
Fax Number	:

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

Provider Enumeration Date	:	02/17/2013
Last Update Date	:	02/17/2013

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