Provider Demographics
NPI:1023012010
Name:BRITT, PETER MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:MICHAEL
Last Name:BRITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15759
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-2459
Mailing Address - Country:US
Mailing Address - Phone:912-355-8188
Mailing Address - Fax:912-356-6970
Practice Address - Street 1:4700 WATERS AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6220
Practice Address - Country:US
Practice Address - Phone:912-350-8436
Practice Address - Fax:912-356-6970
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUMC-1952085R0202X
GA0470572085U0001X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000826834NOtherPEACH STATE HEALTH PLAN
GAN343829OtherWELLCARE
GA000826834NMedicaid
GA52666903015OtherBCBS
GAP00266283OtherRAILROAD MEDICARE
GA000826834NMedicaid
GA000826834NOtherPEACH STATE HEALTH PLAN