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NPI Code Detail

MEDICARE: ALINA V. PETERS

MEDICARE: ALINA V. PETERS
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
11223G0001XGeneral Practice Dentistry4545NC

General Provider Information

NPI Number : 1316064918
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALINA V. PETERS
Provider Business Mailing Address
First Line : 1621 LIVE OAK ST
Second Line :
City : BEAUFORT
State : NC
Zip : 28516-1520
Country : US
Telephone Number : 252-728-2025
Fax Number : 252-728-3326
Provider Business Practice Location Address
First Line : 1621 LIVE OAK ST
Second Line :
City : BEAUFORT
State : NC
Zip : 28516-1520
Country : US
Telephone Number : 252-728-2025
Fax Number : 252-728-3326
Authorized Official
Title or Position : OFFICE ADMIN
Name : MRS. STACY ROSE
Credential :
Telephone Number : 252-728-2025
Provider Enumeration Date : 03/26/2007
Last Update Date : 11/19/2014

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