Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | DC 003776-L | PA |
NPI | 1942237029 |
---|---|
Provider Name | Dr. Gregory Michael Mcpeak |
First Address | Rockledge, PA 19046-4419 |
Second Address | Rockledge, PA 19046-4419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 08/07/2007 |