Provider Demographics
NPI:1962477463
Name:HUNTER, PEGGY O (MD)
Entity Type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:O
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4475 MEDICAL CENTER WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3240
Mailing Address - Country:US
Mailing Address - Phone:561-840-0995
Mailing Address - Fax:561-840-0661
Practice Address - Street 1:3918 VIA POINCIANA STE 10
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2991
Practice Address - Country:US
Practice Address - Phone:561-440-7546
Practice Address - Fax:561-754-7440
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1962477463207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME100128OtherDERMATOLOGY
093011ALYMedicare ID - Type Unspecified