Provider Demographics
NPI:1972823540
Name:MA, PETER H (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:H
Last Name:MA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5784 WIDEWATERS PKWY
Mailing Address - Street 2:FL 2
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-1890
Mailing Address - Country:US
Mailing Address - Phone:315-469-1130
Mailing Address - Fax:315-469-1134
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2306
Practice Address - Country:US
Practice Address - Phone:315-464-4720
Practice Address - Fax:315-464-4905
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH127666207L00000X, 207LP3000X
NY327489207L00000X, 207LP3000X
VA0101268307207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology