Provider Demographics
NPI:1972258036
Name:PETERS, EMILY MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:MARY
Last Name:PETERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MARY
Other - Last Name:NEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:COMMAND SUBMARINE SQUADRON 6/8 MEDICAL DEPARTMENT
Mailing Address - Street 2:2ND STREET
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23511
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:COMMAND SUBMARINE SQUADRON 6/8 MEDICAL DEPARTMENT
Practice Address - Street 2:2ND STREET
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23511
Practice Address - Country:US
Practice Address - Phone:757-499-8721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101279849207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine