MEDICARE: ROBYN H PECKHAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	980660NC	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1154K	OTHER	NC	BCBS
3	D3689	OTHER		MEDCOST
4	6658952	OTHER		CIGNA

General Provider Information

NPI Number	:	1417940867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN H PECKHAM MD

Provider Business Mailing Address
First Line	:	PO BOX 1060
Second Line	:
City	:	FLETCHER
State	:	NC
Zip	:	28732-1060
Country	:	US
Telephone Number	:	828-684-8201
Fax Number	:	828-684-8601

Provider Business Practice Location Address
First Line	:	29 DOCTORS DRIVE
Second Line	:
City	:	FLETCHER
State	:	NC
Zip	:	28732
Country	:	US
Telephone Number	:	828-684-8201
Fax Number	:	828-684-8601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	07/08/2007

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