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General NPI Number Information
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NPI Number | 1841264769
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Entity Type | Individual
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Provider Name | PETER K MCIVER MD
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Gender | Male
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 416 MONTROSE BLVD
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City | GULF BREEZE
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State | FL
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Zip | 32561-4020
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Country | US
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Telephone | 850-501-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 416 MONTROSE BLVD
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City | GULF BREEZE
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State | FL
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Zip | 32561-4020
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Country | US
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Telephone | 850-501-0200
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME44532
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101230201
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 024024
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | M6915
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License Number State | ID
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