Individual
JOHN PEELER SURRATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
804 COHARIE DR, CLINTON, NC 28328-3022
(910) 592-5583
(910) 592-7310
Mailing address
804 COHARIE DR, CLINTON, NC 28328-3022
(910) 592-5583
(910) 592-7310
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
17444
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81010
BLUE CROSS BLUE SHIELD
NC
05
—
8981010
—
NC
Enumeration date
02/14/2006
Last updated
01/04/2012
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