Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | ME52942 | FL |
Y | 208200000X | Surgeon | ME52942 | FL |
Y | 208600000X | Surgeon | ME52942 | FL |
NPI | 1760457907 |
---|---|
Provider Name | Dr. Thomas Guy Peters |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 28/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000477551C | (05) | GA |
0640565-00 | (05) | FL |
B03181 | (02) | FL |
P00228295 | RAILROAD MEDICARE (01) | FL |