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General NPI Number Information
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NPI Number | 1548411796
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Entity Type | Individual
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Provider Name | DAVID HOWARD PECKHAM PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 110 LONG POND RD STE 202
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City | PLYMOUTH
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State | MA
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Zip | 02360-2642
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Country | US
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Telephone | 508-747-4424
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Fax | 508-747-4420
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Provider Business Mailing Address
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Address Line | 8 MARKET XING
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City | PLYMOUTH
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State | MA
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Zip | 02360-7736
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Country | US
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Telephone | 508-224-3800
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2542
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License Number State | MA
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