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Individual

DONALD WALTER PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
791 JONESTOWN RD, WINSTON SALEM, NC 27103-1252
(336) 716-3693
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
28608
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
203711000
WV
01
260050043
RR MEDICARE
01
29247
MEDCOST
01
4757
PARTNERS
01
5457218
AETNA
01
67165
BCBS
05
7140291
VA
05
8967165
NC
05
Q28608
SC
Enumeration date
12/02/2005
Last updated
04/02/2015
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