Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | NC | |
N | 207RC0200X | Critical Care Medicine | NC | |
Y | 207RP1001X | Pulmonary Disease | NC |
NPI | 1598740656 |
---|---|
Provider Name | Stephen Paul Peters |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 10/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10040663 | (05) | VA |
1339N | BCBS (01) | |
2006357000 | (05) | WV |
4110792 | AETNA (01) | |
802880 | PARTNERS (01) | |
891339N | (05) | NC |
C32766 | (02) | |
C6271 | MEDCOST (01) | |
P00037706 | RR MEDICARE (01) | |
Q0051G | (05) | SC |