Individual
EDWARD ARNOLD PECK III
Active
Individual
EDWARD ARNOLD PECK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
0810000910
VA
103TC0700X
Clinical Psychologist
0810000910
VA
103TC0700X
Clinical Psychologist
2228
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007705948
—
VA
01
—
018091
ANTHEM BCBS
VA
01
—
087976
SENTARA MENTAL HEALTH
VA
Enumeration date
05/25/2006
Last updated
10/16/2008
Update your record
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