Provider Demographics
NPI:1508872128
Name:DUIC, PETER C (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:C
Last Name:DUIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5407 BREATHLESS LN
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-9091
Mailing Address - Country:US
Mailing Address - Phone:813-920-6175
Mailing Address - Fax:727-372-3820
Practice Address - Street 1:10730 STATE ROAD 54
Practice Address - Street 2:SUITE 104
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-2217
Practice Address - Country:US
Practice Address - Phone:727-372-3888
Practice Address - Fax:727-372-3820
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84735207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264761300Medicaid
FL51364OtherBCBS OF FLORIDA
FL264761300Medicaid
FL51364OtherBCBS OF FLORIDA
FL51364WMedicare PIN