Individual
LOUISE ANN PECEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2110 DORCHESTER AVE, DORCHESTER, MA 02124-5628
(843) 209-6704
Mailing address
159 RIVERCHASE RD, PINNACLE, NC 27043-8515
(843) 209-6704
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103743
NC
363A00000X
Physician Assistant
363A00000X
CA
363AM0700X
Medical Physician Assistant
PA2582
MA
Other
Enumeration date
06/22/2006
Last updated
12/02/2024
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