Provider Demographics
NPI:1245448711
Name:PEETS, AYESHA KAMEELA (MD)
Entity type:Individual
Prefix:
First Name:AYESHA
Middle Name:KAMEELA
Last Name:PEETS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AYESHA
Other - Middle Name:KAMEELA PEETS
Other - Last Name:TALBOT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:14 VERDMONT VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:SMITH'S PARISH
Mailing Address - State:BERMUDA
Mailing Address - Zip Code:FL02
Mailing Address - Country:BM
Mailing Address - Phone:441-236-7961
Mailing Address - Fax:441-236-7961
Practice Address - Street 1:14 VERDMONT VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:SMITH'S PARISH
Practice Address - State:BERMUDA
Practice Address - Zip Code:FL02
Practice Address - Country:BM
Practice Address - Phone:441-236-7961
Practice Address - Fax:441-236-7961
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116018849390200000X
VA0101247642207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program