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Individual

DR. BRANDON MARK PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
5 MOBILE INFIRMARY CIR, MOBILE, AL 36607-3513
(251) 544-1926
(251) 460-2846
Mailing address
PO BOX 9369, MOBILE, AL 36691-0369
(251) 544-1926
(251) 460-2846

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
052806
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009910878
AL
05
009910879
AL
05
009910881
AL
05
009910882
AL
05
009914027
AL
05
051540438
AL
01
51540438
BC/BS OF AL
AL
01
51540439
BC/BS OF AL
AL
01
51540440
BC/BS OF AL
AL
01
51540441
BC/BS OF AL
AL
01
51540442
BC/BS OF AL
AL
Enumeration date
10/05/2006
Last updated
09/07/2010
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