Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 2015-02351 | NC |
N | 207ND0101X | MOHS-Micrographic Surgeon | 2015-02351 | NC |
NPI | 1013195759 |
---|---|
Provider Name | Dr. Peter L Mattei IV |
First Address | Pinehurst, NC 28374-8594 |
Second Address | Pinehurst, NC 28374-8593 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2008 |
Last Update Date | 03/10/2018 |