Provider Demographics
NPI:1366682841
Name:PELUSO, FRANCIS ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:ROBERT
Last Name:PELUSO
Suffix:
Gender:M
Credentials:DO
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 1005
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-1005
Mailing Address - Country:US
Mailing Address - Phone:864-834-8013
Mailing Address - Fax:
Practice Address - Street 1:1 HAVENWOOD LN
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-9447
Practice Address - Country:US
Practice Address - Phone:864-834-8013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDO 5772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H00502Medicare PIN