Individual
MICHAEL B PEYSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1575 WASHINGTON ST, WATERTOWN, NY 13601-9371
(315) 788-2805
(315) 779-5066
Mailing address
830 WASHINGTON ST, WATERTOWN, NY 13601-4034
(315) 786-7501
(315) 779-5306
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101056084
VA
208600000X
Surgery Physician
Primary
217155
NY
2086X0206X
Surgical Oncology Physician
0101056084
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000534041001
BLUE SHIELD WNY
NY
05
—
03470353
—
NY
05
—
1881671238
—
VA
Enumeration date
12/28/2005
Last updated
02/27/2025
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