Provider Demographics
NPI:1952829012
Name:PIETERMAN, MARIA ANTONIA (LAC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ANTONIA
Last Name:PIETERMAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:MARIEKE
Other - Middle Name:ANTONIA
Other - Last Name:PIETERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:5247 POTEAT RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:27231-9741
Mailing Address - Country:US
Mailing Address - Phone:919-259-5226
Mailing Address - Fax:919-415-1615
Practice Address - Street 1:5247 POTEAT RD
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NC
Practice Address - Zip Code:27231-9741
Practice Address - Country:US
Practice Address - Phone:919-259-5226
Practice Address - Fax:919-415-1615
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC-936171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist