Provider Demographics
NPI:1114287562
Name:BIEBER, PETER STEVEN (BS)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:STEVEN
Last Name:BIEBER
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 LAURELWOOD CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-4600
Mailing Address - Country:US
Mailing Address - Phone:336-294-3952
Mailing Address - Fax:
Practice Address - Street 1:804 LAURELWOOD CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4600
Practice Address - Country:US
Practice Address - Phone:336-294-3952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-19
Last Update Date:2012-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC05405183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist