Individual
DR. JOANNE PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14 DOCTORS CIR, SUITE 3, SUPPLY, NC 28462-4097
(910) 754-7075
(910) 754-2158
Mailing address
14 DOCTORS CIR, SUITE 3, SUPPLY, NC 28462-4097
(910) 754-7075
(910) 754-2158
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200101262
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1200360
UHC IND PROVIDER NUMBER
NC
01
—
12932
BCBS OF NC IND PROVIDER
NC
01
—
20-0109889
TRICARE PROVIDER NUMBER
NC
01
—
7031690
CIGNA IND PROVIDER NUMBER
NC
05
—
8912935
—
NC
01
—
C7595
MEDCOST IND PROVIDER #
NC
Enumeration date
08/13/2006
Last updated
07/09/2007
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