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NPI Code Detail

MEDICARE: DR. STEVEN JAMES PECKHAM MD

MEDICARE: DR. STEVEN JAMES PECKHAM 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
1207ZC0500XCytopathology Physician0101055348VA
2207ZD0900XDermatopathology (Pathology) PhysicianA85691CA
3207ZP0101XAnatomic Pathology PhysicianR1612TX

General Provider Information

NPI Number : 1295794949
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN JAMES PECKHAM MD
Provider Business Mailing Address
First Line : 3300 NACOGDOCHES RD
Second Line : SUITE 110
City : SAN ANTONIO
State : TX
Zip : 78217-3373
Country : US
Telephone Number : 210-646-0890
Fax Number : 210-646-9191
Provider Business Practice Location Address
First Line : 3300 NACOGDOCHES RD
Second Line : SUITE 110
City : SAN ANTONIO
State : TX
Zip : 78217-3373
Country : US
Telephone Number : 210-646-0890
Fax Number : 210-646-9191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2006
Last Update Date : 04/27/2017

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