Individual
PETER LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-2793
Mailing address
PO BOX 9135, ATT:SHARON SILVA, BROOKLINE, MA 02446-9135
(800) 927-0002
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
42489
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2062313
—
MA
01
—
30001165
MEDICAID NH
NH
05
—
683005
—
NY
01
—
7500162
UNITED HEALTHCARE MA
MA
01
—
99277901
NETWORK HEALTH
MA
01
—
AA9223
HARVARD PILGRIM
MA
01
—
B20232601
CIGNA MA
MA
01
—
M09798
BCBS MA
MA
05
—
PL25420
—
RI
Enumeration date
11/02/2005
Last updated
02/19/2010
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