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PETER REIST EBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3400 SPRUCE STREET, PHILADELPHIA, PA 19104-4206
(206) 384-1664
(206) 515-5886
Mailing address
3737 MARKET ST, 7TH FL., PHILADELPHIA, PA 19104
(206) 384-1664

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MA12101200
NJ
2085R0202X
Diagnostic Radiology Physician
Primary
MD482330
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0272895
DEPT OF LABOR AND INDUSTRIES
WA
01
263330
INTERNAL ID-MOTOR VEHICLE ID
05
8395998
WA
01
P00898818
RAILROAD MEDICARE
WA
Enumeration date
10/27/2006
Last updated
10/31/2024
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