MEDICARE: DARIN MATTHEW PECK M.D.

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
1	207Q00000X	Family Medicine Physician	016165	ME

General Provider Information

NPI Number	:	1316995046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARIN MATTHEW PECK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1129
Second Line	:
City	:	GREENVILLE
State	:	ME
Zip	:	04441-1129
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	364 PRITHAM AVE
Second Line	:
City	:	GREENVILLE
State	:	ME
Zip	:	04441
Country	:	US
Telephone Number	:	207-695-5220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	07/08/2007

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