Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | P6499 | TX |
Y | 207VE0102X | Reproductive Endocrinologist | 158261 | NC |
NPI | 1013159094 |
---|---|
Provider Name | Mary Carolyn Peavey |
First Address | Chapel Hill, NC 27599-8744 |
Second Address | Raleigh, NC 27617-8744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2009 |
Last Update Date | 17/03/2018 |