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1871592790

NPI Code Detail

MEDICARE: DR. PETER BETZ MD

MEDICARE: DR. PETER BETZ 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	2084P0800X	Psychiatry Physician	0101230862	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	203639329	OTHER		PCHP PROVIDER NUMBER
2	203639329001	OTHER		TRICARE PROVIDER NUMBER
3	418874	OTHER		VALUE OPTIONS PROVIDER NU
4	186457	OTHER		ANTHEM PROVIDER NUMBER
5	2069439	OTHER		CIGNA BEHAVIOR PROVIDER N
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	O84628	OTHER		SENTARA/OPTIMA PROVIDER N

General Provider Information

NPI Number	:	1871592790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER BETZ MD

Provider Business Mailing Address
First Line	:	1204 FENWICK DR
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24502-2112
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 RIVERMONT AVE
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24503-2030
Country	:	US
Telephone Number	:	434-200-5999
Fax Number	:

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	03/08/2010

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Directions to “ DR. PETER BETZ MD” Practice Location

Language	Start Address	Practice Location

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