Provider Demographics
NPI:1508856436
Name:PEKAL, WIESLAWA A (MD)
Entity Type:Individual
Prefix:
First Name:WIESLAWA
Middle Name:A
Last Name:PEKAL
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:PO BOX 749495
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9495
Mailing Address - Country:US
Mailing Address - Phone:238-432-8331
Mailing Address - Fax:813-321-1296
Practice Address - Street 1:551 BREVARD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2316
Practice Address - Country:US
Practice Address - Phone:828-212-7021
Practice Address - Fax:828-232-8218
Is Sole Proprietor?:No
Enumeration Date:2005-10-22
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800112207RH0000X, 207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC36-71144OtherUNITED HEALTHCARE
NC36-71144OtherCIGNA
NC891108LMedicaid
NC90932OtherMEDCOST
NC1108LOtherBLUE CROSS BLUE SHIELD NC
NC90932OtherMEDCOST
NC2249261Medicare PIN
NC830004603Medicare PIN
NC1108LOtherBLUE CROSS BLUE SHIELD NC
NCNC6600AMedicare PIN
NC2249261BMedicare PIN