MEDICARE: MR. PETER REX HONIG 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	207QA0505X	Adult Medicine Physician	OS006248L	PA

General Provider Information

NPI Number	:	1194777466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PETER REX HONIG DO

Provider Business Mailing Address
First Line	:	1805 S BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-2115
Country	:	US
Telephone Number	:	215-467-7666
Fax Number	:	215-467-1780

Provider Business Practice Location Address
First Line	:	1805 S BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-2115
Country	:	US
Telephone Number	:	215-467-7666
Fax Number	:	215-467-1780

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	02/23/2012

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