| Doctor Name: | DR. PETER JOSEPH PROCIUK |
| NPI Number: | 1891996708 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD039488L |
| Business Practice Address: | 322 N High St West Chester, PA - 193802650 |
| Business Phone Number: | 6107015702 |
| Business Fax Number: | 6107014225 |
| Mailing Address: | 322 N High St, WEST CHESTER |
| State: | PA |
| Postal Code: | 193802650 |
| Phone Number: | 6107015702 |
| Fax Number: | 6107014225 |
| NPI Enumeration Date: | 05/29/2007 |
| NPI Last Update Date: | 01/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD039488L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |