Healthcare Provider Details

I. General information

NPI: 1861968950
Provider Name (Legal Business Name): JOSHUA PEIPER DN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 10/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 EAGLE RANCH RD NW APT 523
ALBUQUERQUE NM
87114-6233
US

IV. Provider business mailing address

9250 EAGLE RANCH RD NW APT 523
ALBUQUERQUE NM
87114-6233
US

V. Phone/Fax

Practice location:
  • Phone: 505-309-0540
  • Fax:
Mailing address:
  • Phone: 505-309-0540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number01030
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: