MEDICARE: DR. CHERYL PEGUS MD, MPH

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	207R00000X	Internal Medicine Physician	184455	NY

General Provider Information

NPI Number	:	1386758050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL PEGUS MD, MPH

Provider Business Mailing Address
First Line	:	1121 BETHLEHEM PIKE
Second Line	:	#60-284
City	:	SPRING HOUSE
State	:	PA
Zip	:	19477-1102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1121 BETHLEHEM PIKE
Second Line	:	#60-284
City	:	SPRING HOUSE
State	:	PA
Zip	:	19477-1102
Country	:	US
Telephone Number	:	215-565-6075
Fax Number	:

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	07/08/2007

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