Individual
PETER J NEIDENBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
52 HOSPITAL DR STE 3A, COLUMBUS, NC 28722-8516
(828) 894-2473
(828) 894-2390
Mailing address
52 HOSPITAL DR STE 3A, COLUMBUS, NC 28722-8516
(828) 894-2473
(828) 894-2390
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
9501356
NC
207N00000X
Dermatology Physician
MMD16384MD
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2214227A
PTAN
NC
01
—
9501356
STATE LICENSE
NC
01
—
MMD16384MD
STATE LICENCE
SC
Enumeration date
05/03/2006
Last updated
12/21/2023
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