Individual
PETER MANNING JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1002 N CHURCH ST, SUITE 103, GREENSBORO, NC 27401-1439
(336) 272-6133
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-7000
(336) 851-8427
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
30558
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060039916
RR MEDICARE
—
01
—
1142
PARTNERS MEDICARE
—
01
—
2500770
UNITED HEALTHCARE
—
01
—
47479
BCBS
NC
01
—
561240263
COMMERCIAL
—
05
—
8947479
—
NC
Enumeration date
01/05/2007
Last updated
09/03/2013
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