Individual
PETER ANKROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
420 E 2ND AVE, SUITE 103, ROME, GA 30161-3224
(706) 509-3278
(706) 509-4608
Mailing address
304 TURNER MCCALL BLVD SW, ROME, GA 30165-5621
(706) 509-5000
(706) 509-4608
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
041256
GA
207P00000X
Emergency Medicine Physician
Primary
2255
TN
207R00000X
Internal Medicine Physician
041256
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000702798J
—
GA
05
—
00702798B
—
GA
01
—
P00428756
RAILROAD MEDICARE
—
Enumeration date
07/26/2006
Last updated
10/19/2016
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