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Individual
WENDY PECK
Active
Individual
WENDY PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MA056996
PA
207Q00000X
Family Medicine Physician
MA056996
PA
207R00000X
Internal Medicine Physician
MA056996
PA
363A00000X
Physician Assistant
Primary
MA056996
PA
363L00000X
Nurse Practitioner
MA056996
PA
Other
Enumeration date
12/01/2014
Last updated
02/05/2016
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