MEDICARE: DR. PETER WESTERVELT MD

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	207RX0202X	Medical Oncology Physician	2006008771	MO
2	207RX0202X	Medical Oncology Physician	211561	MA
3	207RX0202X	Medical Oncology Physician	MD27026	ME

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	:	1043292246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER WESTERVELT MD

Provider Business Mailing Address
First Line	:	329 MAINE ST
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-3310
Country	:	US
Telephone Number	:	207-373-2266
Fax Number	:	314-454-5902

Provider Business Practice Location Address
First Line	:	329 MAINE ST
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-3310
Country	:	US
Telephone Number	:	207-373-2266
Fax Number	:	314-454-5902

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	11/28/2023

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