Individual
JOHN CALEB PEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-5611
(864) 455-7000
(864) 454-1144
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
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
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