Basic Information
| Provider Information | |||||||||
| NPI: | 1053302828 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VIEIRA | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 908 ALLEN ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011182533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137967494 | ||||||||
| FaxNumber: | 4137967498 | ||||||||
| Practice Location | |||||||||
| Address1: | 908 ALLEN ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011182533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137967494 | ||||||||
| FaxNumber: | 4137967498 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2005 | ||||||||
| LastUpdateDate: | 03/09/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 74858 | MA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 74858 | MA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.