Individual
DR. PETER BOHDAN BANDERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
217 KEDRON AVE, FOLSOM, PA 19033-1310
(610) 532-2633
(610) 532-7856
Mailing address
1 E BEACON LIGHT LN, CHESTER, PA 19013-4433
(610) 532-2633
(610) 532-7856
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD041244L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012374630001
—
PA
Enumeration date
07/17/2006
Last updated
11/14/2017
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