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Organization
PENINSULA EYE CENTER PA
Active
Organization
PENINSULA EYE CENTER PA
Active
Other names
Peninsula Eye Surgeons PA Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY P LUPPENS M.D. (PRESIDENT)
(410) 749-9290
Entity
Organization
Contact information
Practice address
101 MILFORD STREET, SALISBURY, MD 21804
(410) 749-9290
(410) 543-9087
Mailing address
101 MILFORD STREET, SALISBURY, MD 21804
(410) 749-9290
(410) 543-9087
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
MD
207W00000X
Ophthalmology Physician
—
NULL
207W00000X
Ophthalmology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000134502
—
DE
01
—
20885
MAMSI-UNITED HEALTH CARE
—
05
—
915111700
—
MD
01
—
H788PE
CAREFIRST BLUE SHIELD
MD
01
—
T699
CAREFIRST BS-FEDERAL
—
Enumeration date
03/19/2007
Last updated
11/14/2016
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