Peacock, Mark D

Peacock, Mark D is an sole proprietor health care provider with primary practice located at 15940 Northcross Dr Suite C, Huntersville NC 28078-5062. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Peacock, Mark D can be contacted via phone (704) 896-7005.

Contact Information

Primary practice address
15940 Northcross Dr Suite C Huntersville NC 28078-5062
Phone: (704) 896-7005
Fax: (704) 896-7115
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 30568 North Carolina

Profile Details

NPI number 1699734848
LBN Legal business name Peacock, Mark D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 17th, 2006
Last updated Oct 31st, 2011 - about 13 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 1699734848 NPPES
North Carolina MEDICAID 8966374

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