Individual
VIVIAN MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2000 NEUSE BLVD, NEW BERN, NC 28560-3449
(252) 633-8111
Mailing address
2000 NEUSE BLVD, NEW BERN, NC 28560-3449
(252) 633-8111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200401561
NC
208M00000X
Hospitalist Physician
Primary
200401561
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139K4
BCBS OF NC
NC
05
—
5900914
—
NC
Enumeration date
06/06/2006
Last updated
02/02/2015
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