Provider Demographics
NPI:1053379669
Name:ASH, PETER (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:ASH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12 EXECUTIVE PARK DR NE
Mailing Address - Street 2:CHILD PSYCHIATRY, SUITE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2206
Mailing Address - Country:US
Mailing Address - Phone:404-727-3973
Mailing Address - Fax:404-727-3155
Practice Address - Street 1:12 EXECUTIVE PARK DR NE
Practice Address - Street 2:CHILD PSYCHIATRY, SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2206
Practice Address - Country:US
Practice Address - Phone:404-727-3973
Practice Address - Fax:404-727-3155
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2017-04-15
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Provider Licenses
StateLicense IDTaxonomies
GA0366782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A78907Medicare UPIN