Provider Demographics
NPI:1447258777
Name:PLUMERI, PETER A (DO, DACP)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:A
Last Name:PLUMERI
Suffix:
Gender:M
Credentials:DO, DACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8170
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-8170
Mailing Address - Country:US
Mailing Address - Phone:856-218-0463
Mailing Address - Fax:856-218-0099
Practice Address - Street 1:445 HURFFVILLE CROSSKEYS RD
Practice Address - Street 2:STE B-10
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2337
Practice Address - Country:US
Practice Address - Phone:856-218-0200
Practice Address - Fax:856-218-0099
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25 MB03113000207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PL170934Medicare ID - Type Unspecified
C53699Medicare UPIN