Provider Demographics
NPI:1396775326
Name:LIGGETT, PETER E (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:E
Last Name:LIGGETT
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 1:65 OUTPOST LN
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29928-3822
Mailing Address - Country:US
Mailing Address - Phone:203-980-0612
Mailing Address - Fax:
Practice Address - Street 1:15 LAFAYETTE PLACE
Practice Address - Street 2:SUITE A
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-2277
Practice Address - Country:US
Practice Address - Phone:203-288-2020
Practice Address - Fax:203-288-2470
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36165207W00000X, 207WX0108X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0108XAllopathic & Osteopathic PhysiciansOphthalmologyUveitis and Ocular Inflammatory Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
180000647Medicare ID - Type Unspecified
E93053Medicare UPIN