Individual
PAUL SAMUEL PEGRAM JR.
Active
Individual
PAUL SAMUEL PEGRAM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
16925
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29201
MEDCOST
—
01
—
3528
PARTNERS
—
01
—
5529121
AETNA
—
05
—
6010016
—
VA
01
—
66717
BCBS
—
05
—
8966717
—
NC
05
—
Q16925
—
SC
Enumeration date
12/09/2005
Last updated
01/11/2008
Update your record
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