Mentor, Peggy
Mentor, Peggy is an individual health care provider with primary practice located at 940 Belmont St , Brockton MA 02301-5596. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as her primary health care specialty. Mentor, Peggy can be contacted via phone (857) 364-4418.Contact Information
Primary practice address
940 Belmont St
Brockton MA 02301-5596
Phone: (857) 364-4418
Fax: (774) 826-3157
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | C53573 | California |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | 262150 | Massachusetts |
Profile Details
| NPI number | 1023006525 |
|---|---|
| LBN Legal business name | Mentor, Peggy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2005 |
| Last updated | Mar 21st, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023006525 | NPPES |
| California | MEDICAID | 1023006525 |
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