Individual
AUSTIN ELLERBE PEAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101251103
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116019471
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356548796
—
VA
01
—
224564
ANTHEM
VA
01
—
P01200810
MEDICARE R/R
VA
Enumeration date
06/29/2007
Last updated
05/19/2023
Update your record
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