Bettendorf, Anna Peacock

Bettendorf, Anna Peacock is an sole proprietor health care provider with primary practice located at 2208 S 17Th St Second Floor, Wilmington NC 28401-7593. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Bettendorf, Anna Peacock can be contacted via phone (910) 251-6755.

Contact Information

Primary practice address
2208 S 17Th St Second Floor Wilmington NC 28401-7593
Phone: (910) 251-6755
Fax: (910) 458-8619
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 9400419 North Carolina

Profile Details

NPI number 1679765648
LBN Legal business name Bettendorf, Anna Peacock
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 14th, 2007
Last updated Aug 14th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679765648 NPPES
North Carolina Other 130AX BLUE CROSS/ BLUE SHIELD
North Carolina MEDICAID 89130AX BLUE CROSS/ BLUE SHIELD

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