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General NPI Number Information
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NPI Number | 1558326611
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Entity Type | Organization
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Legal Business Name | MICHAEL W. PEADEN MD PC
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 115 HERREN HILL RD
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City | TALLASSEE
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State | AL
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Zip | 36078-1276
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Country | US
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Telephone | 334-283-3477
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Fax |
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Provider Business Mailing Address
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Address Line | 115 HERREN HILL RD
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City | TALLASSEE
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State | AL
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Zip | 36078-1276
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Country | US
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Telephone | 334-283-3477
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JANE S BELLEW
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Credential |
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Telephone | 334-283-3477
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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 | 15415
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License Number State | AL
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