Provider Demographics
NPI:1952515116
Name:PETER, ARLEY A (MD)
Entity type:Individual
Prefix:
First Name:ARLEY
Middle Name:A
Last Name:PETER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 36TH ST STE 200B
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6588
Mailing Address - Country:US
Mailing Address - Phone:772-999-3996
Mailing Address - Fax:866-506-8393
Practice Address - Street 1:1285 36TH ST STE 200B
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6588
Practice Address - Country:US
Practice Address - Phone:772-999-3996
Practice Address - Fax:866-506-8393
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40817207RC0000X
FLME93562207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100020140Medicaid
OH2729837Medicaid
FL113657500Medicaid
FL1496GOtherBCBS
FL004031900Medicaid
WV3810009027Medicaid
WV001967511OtherMOUNTAIN STATE BCBS
KY00000521721OtherANTHEM BLUECROSS & BLUESH
WV3810009027Medicaid
KYP00652879Medicare PIN
P00461704Medicare PIN
OH4214822Medicare PIN
WV001967511OtherMOUNTAIN STATE BCBS
KY00788006Medicare PIN
KY00000521721OtherANTHEM BLUECROSS & BLUESH
FLI0825AMedicare PIN
KY0257223Medicare PIN