Healthcare Provider Details

I. General information

NPI: 1881776151
Provider Name (Legal Business Name): SUSAN SAIK PEEBLES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENISE SUSAN SAIK M.D.

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 VEAZEY DR
BUTNER NC
27509-1668
US

IV. Provider business mailing address

3006 MAIL SERVICE CTR
RALEIGH NC
27699-3006
US

V. Phone/Fax

Practice location:
  • Phone: 919-764-2000
  • Fax: 919-764-2000
Mailing address:
  • Phone: 919-855-4700
  • Fax: 919-508-0955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number28691
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number28691
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: