Provider Demographics
NPI:1407039084
Name:PENINSULA OBSTETRICS GYNECOLOGY
Entity Type:Organization
Organization Name:PENINSULA OBSTETRICS GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:NAPIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-546-3120
Mailing Address - Street 1:1205 PEMBERTON DR STE 104
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-2483
Mailing Address - Country:US
Mailing Address - Phone:410-546-3120
Mailing Address - Fax:410-546-3128
Practice Address - Street 1:1205 PEMBERTON DR STE 104
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2483
Practice Address - Country:US
Practice Address - Phone:410-546-3120
Practice Address - Fax:410-546-3128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS041Medicare PIN