Provider Demographics
NPI:1487626800
Name:WECHGELAER, PETER (MD MPH)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:WECHGELAER
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:102 OAK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-9624
Mailing Address - Country:US
Mailing Address - Phone:252-447-1691
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL CLINIC MCAS NEW RIVER
Practice Address - Street 2:PSC BOX 21034
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28545-1034
Practice Address - Country:US
Practice Address - Phone:910-449-6500
Practice Address - Fax:910-449-6532
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010546902083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine