Individual
DR. PETER AUGUSTINOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 PEARL ST, SUITE 2700, BROCKTON, MA 02301-2864
(508) 584-4104
(508) 584-4105
Mailing address
960 MASSACHUSETTS AVE, PROVIDER ENROLLMENT STE 2, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
157481
MA
208600000X
Surgery Physician
157481
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164992
—
MA
Enumeration date
03/15/2006
Last updated
03/10/2025
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