Individual
JOHN CALEB PEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13249
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110174882
RR MEDICARE
SC
01
—
1134486
CIGNA ID
SC
05
—
132494
—
SC
01
—
4586835
AETNA ID
SC
01
—
576007863071
BLUECHOICE HEALTHPLAN ID
SC
01
—
576007863095
BCBS OF SC ID
SC
01
—
P00801548
RR MEDICARE
SC
Enumeration date
05/04/2006
Last updated
04/15/2013
Update your record
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