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Individual

REGINALD DEMETRIUS PEEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
950 INDIAN TRL RD NW, SUITE 5D, LILBURN, GA 30047-1721
(404) 600-5563
Mailing address
2419 LAUREL CIR NW, ATLANTA, GA 30311-1237
(404) 277-9264

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
063002
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003152731A
GA
Enumeration date
07/15/2009
Last updated
06/13/2016
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