Healthcare Provider Details

I. General information

NPI: 1932668274
Provider Name (Legal Business Name): ANDREW PETER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

PO BOX 3090
DURHAM NC
27715-3090
US

V. Phone/Fax

Practice location:
  • Phone: 919-668-4000
  • Fax:
Mailing address:
  • Phone: 919-668-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number2026-03212
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: