Peck, Evan R

Peck, Evan R is an individual health care provider with primary practice located at 525 Okeechobee Blvd 14Th Floor, West Palm Beach FL 33401-6349. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Peck, Evan R can be contacted via phone (561) 804-0200.

Contact Information

Primary practice address
525 Okeechobee Blvd 14Th Floor West Palm Beach FL 33401-6349
Phone: (561) 804-0200
Fax: (561) 804-0222
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 104554 Minnesota
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 52325 Minnesota
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X ME 106449 Florida

Profile Details

NPI number 1861645921
LBN Legal business name Peck, Evan R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2008
Last updated Jul 8th, 2010 - about 14 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 1861645921 NPPES
Minnesota MEDICAID ENROLLED

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