Individual
DR. STEPHEN L PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
4301038298
MI
207RI0011X
Interventional Cardiology Physician
Primary
4301038298
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1394115
—
MI
01
—
25-31067
PHP/IBA
MI
01
—
P54643
BCN
ME
01
—
SP038298
BCBS
MI
Enumeration date
09/22/2006
Last updated
06/11/2015
Update your record
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