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General NPI Number Information
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NPI Number | 1215647888
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Entity Type | Individual
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Provider Name | PETER MATTHEW PRICE
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Gender | Male
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 4117 CHERRY MILL CT
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3858
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Country | US
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Telephone | 817-707-7511
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Fax |
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Provider Business Mailing Address
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Address Line | 4117 CHERRY MILL CT
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3858
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Country | US
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Telephone | 817-707-7511
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | 46260655
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License Number State | NC
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