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Individual
BROOKS A PETERS
Active
Individual
BROOKS A PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC003137L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0081163000
INDEPENDENCE BLUE CROSS
PA
05
—
041185035
—
PA
01
—
2701176
EVERCARE
PA
01
—
480006513
RAILROAD MEDICARE PALMETT
—
Enumeration date
08/07/2006
Last updated
09/29/2020
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