Individual
PETER ILLEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 N BROADWAY ST, WEINBERG BLDG. RM. 2242, BALTIMORE, MD 21231-2410
(410) 502-5160
Mailing address
PO BOX 64478, BALTIMORE, MD 21264-4478
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
225049
NY
207ZP0101X
Anatomic Pathology Physician
Primary
D62986
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408004100
—
MD
Enumeration date
08/29/2005
Last updated
01/05/2013
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