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Individual
PETE S COURY
Active
Individual
PETE S COURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27809
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0763830
BLUE CROSS BLUE SHIELD
AZ
01
—
POO161560
RAILROAD MEDICARE
AZ
01
—
Z83970
PTAN
—
Enumeration date
09/26/2005
Last updated
12/31/2013
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