Individual
GARY L. PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 SUMMER STREET, SUITE 320, WORCESTER, MA 01608
(508) 368-3140
(508) 368-3143
Mailing address
5 NEPONSET ST FL STREET2, WORCESTER, MA 01606-2714
(508) 368-5532
(508) 368-3143
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
46267
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6196101
—
MA
Enumeration date
12/13/2005
Last updated
11/13/2018
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