Individual
PETER ERCOLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1655 WAKE DRIVE, STE 101, WAKE FOREST, NC 27587
(919) 556-4779
(919) 556-5277
Mailing address
3004 BELSPRING LN, RALEIGH, NC 27612-5229
(919) 782-2783
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89126J5
—
NC
Enumeration date
06/30/2005
Last updated
07/08/2007
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