Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 2003-00501 | NC |
NPI | 1124192737 |
---|---|
Provider Name | Dr. Peter F Mcilveen |
First Address | Elkin, NC 28621-2212 |
Second Address | Elkin, NC 28621-2212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 15/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8913340 | (05) | NC |
H83560 | (02) | NC |