Individual
PETER A TUCICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
108 SAKONNET TRL, PINEHURST, NC 28374-6802
(910) 215-9099
Mailing address
35 MEMORIAL DR, FIRST HEALTH, PINEHURST, NC 28374-8708
(910) 215-9099
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200400768
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1370J
BLUE CROSS PROV NUMBER
NC
05
—
891370J
—
NC
Enumeration date
03/01/2007
Last updated
08/02/2014
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