Provider Demographics
NPI:1043327497
Name:OHARA, PEGGY E (MD)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:E
Last Name:OHARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CISCO RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1907
Mailing Address - Country:US
Mailing Address - Phone:828-269-8126
Mailing Address - Fax:
Practice Address - Street 1:4 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4533
Practice Address - Country:US
Practice Address - Phone:828-269-8126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9819208000000X
NC2010-01187208000000X
NC2010011872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1043327497Medicaid
MT000093995OtherBLUECROSSBLUESHIELD
MT0060554Medicaid
MT000093995OtherBLUECROSSBLUESHIELD