Provider Demographics
NPI:1417931569
Name:KEEFE, PETER M (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:M
Last Name:KEEFE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5 NEPONSET ST FL STREET2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-832-5917
Mailing Address - Fax:508-832-5751
Practice Address - Street 1:385 SOUTHBRIDGE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2498
Practice Address - Country:US
Practice Address - Phone:508-832-5917
Practice Address - Fax:508-832-5751
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2019-03-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA74156208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
917826OtherFIRST HEALTH
J12537OtherBLUE SHIELD HMO BLUE
J12537OtherMEDICARE B
042472266OtherPRIVATE HEALTHCARE SYSTEM
J12537OtherBLUE SHIELD INDEMNITY
29198OtherCHILDRENS MEDICAL SECURIT
740020OtherTUFTS HEALTH PLAN
AA1174OtherHARVARD PILGRIM HEALTHCAR
29198OtherHEALTHY START
J12537OtherBLUE CARE ELECT
784150OtherMVP HEALTH CARE
9900829OtherFALLON COMMUNITY HEALTH P
042472266OtherONE HEALTH PLAN
042472266OtherTHREE RIVERS
042472266OtherTRICARE CHAMPUS
7538260OtherCIGNA
042472266OtherHEALTHCARE VALUE MANAGEME
7157271OtherAETNA US HEALTHCARE
9900829OtherFALLON COMMUNITY HEALTH P
J12537OtherBLUE SHIELD INDEMNITY