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NPI Code Detail

MEDICARE: PEGGY JO ROBINSON PA-C

MEDICARE:   PEGGY JO ROBINSON  PA-C
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
1363A00000XPhysician Assistant101578NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1101578OTHERNCMEDICAL LICENSE

General Provider Information

NPI Number : 1619037041
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEGGY JO ROBINSON PA-C
Provider Business Mailing Address
First Line : 1728 FORDHAM BLVD
Second Line : 151 RAM'S PLAZA
City : CHAPEL HILL
State : NC
Zip : 27514-2397
Country : US
Telephone Number : 919-968-1985
Fax Number : 919-942-0038
Provider Business Practice Location Address
First Line : 1728 FORDHAM BLVD
Second Line : 151 RAM'S PLAZA
City : CHAPEL HILL
State : NC
Zip : 27514-2397
Country : US
Telephone Number : 919-968-1985
Fax Number : 919-942-0038
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 07/09/2007

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