Healthcare Provider Details

I. General information

NPI: 1417940867
Provider Name (Legal Business Name): ROBYN H PECKHAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 DOCTORS DRIVE
FLETCHER NC
28732
US

IV. Provider business mailing address

PO BOX 1060
FLETCHER NC
28732-1060
US

V. Phone/Fax

Practice location:
  • Phone: 828-684-8201
  • Fax: 828-684-8601
Mailing address:
  • Phone: 828-684-8201
  • Fax: 828-684-8601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number980660NC
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: