MEDICARE: DR. KIMBERLY CARTER PECK M.D.

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	207R00000X	Internal Medicine Physician	200100521	NC
2	207RR0500X	Rheumatology Physician	200100521	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	:	1952375438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY CARTER PECK M.D.

Provider Business Mailing Address
First Line	:	667 KINGSBOROUGH SQ STE 101
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-4999
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 PLANK BRIDGE RD CT UNIT B
Second Line	:
City	:	CAMDEN
State	:	NC
Zip	:	27921-7027
Country	:	US
Telephone Number	:	252-331-1829
Fax Number	:

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	03/19/2024

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Directions to “ DR. KIMBERLY CARTER PECK M.D.” Practice Location

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