Individual
DR. PETER ROBERT ENNEVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 N ELAM AVE, GREENSBORO, NC 27403-1118
(336) 832-1100
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
9500567
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11934
PARTNERS MEDICARE
NC
01
—
30661
BCBS NC
NC
01
—
5103108
AETNA
NC
01
—
58409
MEDCOST
NC
05
—
8930661
—
NC
Enumeration date
05/16/2006
Last updated
09/17/2021
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