MEDICARE: DR. PETER ELLZEY GEE M.D.

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	174400000X	Specialist	55192	MA

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	:	1104890268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER ELLZEY GEE M.D.

Provider Business Mailing Address
First Line	:	92 MONTVALE AVE
Second Line	:	STONEHAM
City	:	STONEHAM
State	:	MA
Zip	:	02180-3647
Country	:	US
Telephone Number	:	781-662-2229
Fax Number	:	781-662-1811

Provider Business Practice Location Address
First Line	:	92 MONTVALE AVE
Second Line	:	STONEHAM
City	:	STONEHAM
State	:	MA
Zip	:	02180-3647
Country	:	US
Telephone Number	:	781-662-2229
Fax Number	:	781-662-1811

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	04/09/2014

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