Individual
PETER J MACANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
703 E MARSHALL AVE STE 5008, LONGVIEW, TX 75601
(903) 315-4880
Mailing address
PO BOX 86098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
04-27251
KS
207RC0000X
Cardiovascular Disease Physician
16804
ND
207RC0000X
Cardiovascular Disease Physician
Primary
S0731
TX
207RI0011X
Interventional Cardiology Physician
04-27251
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100301810D
—
KS
05
—
396191401
—
TX
01
—
P02220467
MEDICARE RAIL ROAD
TX
Enumeration date
01/12/2006
Last updated
04/15/2023
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