Provider Demographics
NPI:1679520316
Name:MONOSON, PETER ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ALLEN
Last Name:MONOSON
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 1:124 ESTUARY DR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-3869
Mailing Address - Country:US
Mailing Address - Phone:772-234-8681
Mailing Address - Fax:
Practice Address - Street 1:50 HOSPITAL DR STE 3B2
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5248
Practice Address - Country:US
Practice Address - Phone:828-687-0088
Practice Address - Fax:828-684-6693
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11926207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008949Medicaid
NH30203022Medicaid
NHRE6749Medicare ID - Type Unspecified
B37778Medicare UPIN