Individual
MRS. MADHAVI LATHA PEECHARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
10589 E NC HIGHWAY 97, ROCKY MOUNT, NC 27803-9208
(252) 442-1807
(252) 442-1649
Mailing address
855 GOLD HILL RD, STE 106, FORT MILL, SC 29708-8075
(252) 451-2700
(252) 451-2702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2011-01382
NC
207Q00000X
Family Medicine Physician
BP10032241
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5919404
—
NC
Enumeration date
06/19/2008
Last updated
04/06/2017
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