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General NPI Number Information
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NPI Number | 1063654929
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Entity Type | Organization
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Legal Business Name | PETER WROBEL MD PC
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 1720 OLD REYNOLDS ST
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City | WAYCROSS
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State | GA
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Zip | 31501-1036
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Country | US
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Telephone | 912-283-1359
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Fax | 912-283-1360
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Provider Business Mailing Address
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Address Line | 1718 REYNOLDS STREET
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City | WAYCROSS
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State | GA
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Zip | 31501-4574
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Country | US
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Telephone | 912-283-1359
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Fax | 912-283-1362
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Authorized Official
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Title or Position | PRACTITIONER/OWNER
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Name | DR. PETER WROBEL
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Credential | M. D.
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Telephone | 912-283-1359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 040285
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License Number State | GA
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