Individual
MR. PETER BECK WOGLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
218 COOPER HILL RD, WINDSOR, NC 27983-8501
(252) 794-8600
Mailing address
1305 MEADOW RD, COLERAIN, NC 27924-9014
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
101652
NC
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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