# PETER ROGER DEVERSA MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902102502
- **Authorized official:** PETER ROGER DEVERSA MD (SOLE MEMBER)
- **Authorized official phone:** (423) 802-0607

## Contact information

- **Practice address:** 709 WALNUT ST, CHATTANOOGA, TN 37402-1916
- **Practice address phone:** (423) 643-2576
- **Mailing address:** 979 E 3RD ST, SUITE B-1001, CHATTANOOGA, TN 37403-2136
- **Mailing address phone:** (423) 643-2576
- **Mailing address fax:** (423) 648-4570

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208M00000X | Hospitalist Physician | — | NULL | Yes |
| 208M00000X | Hospitalist Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/31/2011
- **Last updated:** 01/31/2011