Provider Demographics
NPI:1841323938
Name:JAMES, PETER GERARD (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:GERARD
Last Name:JAMES
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 1:17083 SW 92ND AVE.
Mailing Address - Street 2:
Mailing Address - City:VILLAGE OF PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-4507
Mailing Address - Country:US
Mailing Address - Phone:786-242-7869
Mailing Address - Fax:786-242-7221
Practice Address - Street 1:17083 SW 92ND AVE.
Practice Address - Street 2:
Practice Address - City:VILLAGE OF PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-4507
Practice Address - Country:US
Practice Address - Phone:786-242-7869
Practice Address - Fax:786-242-7221
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 47313208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery