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General NPI Number Information
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NPI Number | 1417936576
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Entity Type | Individual
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Provider Name | PETER M BLEYER MD
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Gender | Male
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 14508 JAMES B WHITE HWY S
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City | TABOR CITY
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State | NC
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Zip | 28463-8358
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Country | US
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Telephone | 910-653-7000
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Fax | 910-653-7004
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Provider Business Mailing Address
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Address Line | PO BOX 602530
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City | CHARLOTTE
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State | NC
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Zip | 28260-2530
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Country | US
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Telephone | 910-653-7000
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Fax | 910-653-7004
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 32240
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2013-00275
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License Number State | NC
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