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NPI Code Detail

MEDICARE: DR. PETER J MARSH PHARMD

MEDICARE: DR. PETER J MARSH PHARMD
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
1183500000XPharmacist26488MA
2183500000XPharmacist20168NC

General Provider Information

NPI Number : 1396732699
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER J MARSH PHARMD
Provider Business Mailing Address
First Line : 2125 CLOVERDALE AVE
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-2506
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2125 CLOVERDALE AVE
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-2506
Country : US
Telephone Number : 336-723-0561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2005
Last Update Date : 09/06/2017

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