Individual
DR. PETER THOMAS FORTKORT
Active
Individual
DR. PETER THOMAS FORTKORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
95-00577
NC
207R00000X
Internal Medicine Physician
Primary
9500577
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649362138
—
NC
05
—
5300138
—
NC
05
—
N00579
—
SC
Enumeration date
09/29/2006
Last updated
08/22/2019
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