Individual
TODD PHILLIP PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103
(336) 768-3212
(336) 768-9019
Mailing address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103-6983
(336) 768-3212
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2012-01209
NC
207L00000X
Anesthesiology Physician
52747
TN
390200000X
Student in an Organized Health Care Education/Training Program
165574
NC
Other
Enumeration date
06/16/2010
Last updated
11/13/2019
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