Individual
DR. SUSAN D PECK
Active
Individual
DR. SUSAN D PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
OS004392L
PA
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
OS004392L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01808201
CAPITAL BC / KEYSTONE
PA
05
—
097088207
—
PA
01
—
1519553
GATEWAY
PA
01
—
PE427802
PA BLUE SHIELD
PA
Enumeration date
01/11/2006
Last updated
03/08/2023
Update your record
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