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NPI Code Detail

MEDICARE: PETER JOHN DORTON MD

MEDICARE: PETER JOHN DORTON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician20449SC
2207Q00000XFamily Medicine Physician2013-00739NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2080187887OTHERMEDCOST

General Provider Information

NPI Number : 1083655211
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER JOHN DORTON MD
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7804 FAIRVIEW RD STE A
Second Line :
City : CHARLOTTE
State : NC
Zip : 28226-4999
Country : US
Telephone Number : 704-316-3136
Fax Number : 704-316-3140
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 04/05/2023

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Directions to “ PETER JOHN DORTON MD” Practice Location

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