MEDICARE: DR. PETER N PURCELL 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	208600000X	Surgery Physician	97-01115	NC
2	2086S0129X	Vascular Surgery Physician	97-01115	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

General Provider Information

NPI Number	:	1932133170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER N PURCELL MD

Provider Business Mailing Address
First Line	:	924 N HOWE ST
Second Line	:
City	:	SOUTHPORT
State	:	NC
Zip	:	28461-3038
Country	:	US
Telephone Number	:	910-457-3800
Fax Number	:	910-457-3842

Provider Business Practice Location Address
First Line	:	924 N HOWE ST
Second Line	:
City	:	SOUTHPORT
State	:	NC
Zip	:	28461-3038
Country	:	US
Telephone Number	:	910-454-1192
Fax Number	:	910-457-3842

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	01/29/2026

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