Individual
MR. MICHAEL V. PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1400 E 2ND ST, DEFIANCE, OH 43512-2440
(419) 784-1414
Mailing address
1400 E 2ND ST, DEFIANCE, OH 43512-2440
(419) 784-1414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001391
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0669870
—
OH
Enumeration date
11/23/2005
Last updated
02/27/2014
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