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General NPI Number Information
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NPI Number | 1912056243
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Entity Type | Organization
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Legal Business Name | PENINSULA ALLERGY & ASTHMA ASSOCIATES P A
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | 201 PINE BLUFF ROAD SUITE 28
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City | SALISBURY
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State | MD
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Zip | 21801
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Country | US
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Telephone | 410-742-5599
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Fax | 410-742-4873
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Provider Business Mailing Address
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Address Line | 201 PINE BLUFF ROAD SUITE 28
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City | SALISBURY
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State | MD
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Zip | 21801
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Country | US
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Telephone | 410-742-5599
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Fax | 410-742-4873
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Authorized Official
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Title or Position | PRESIDENT
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Name | CURT M WATKINS
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Credential | M.D.
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Telephone | 410-742-5599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | C10005689
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | D0050650
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License Number State | MD
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