Provider Demographics
NPI:1912084138
Name:ADLAND, PETER F (MD,PA)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:F
Last Name:ADLAND
Suffix:
Gender:M
Credentials:MD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 W COLONY PL
Mailing Address - Street 2:STE 230
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5589
Mailing Address - Country:US
Mailing Address - Phone:919-489-9316
Mailing Address - Fax:
Practice Address - Street 1:21 WEST COLONY PLACE
Practice Address - Street 2:SUITE 230
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5589
Practice Address - Country:US
Practice Address - Phone:919-489-9316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC242142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10423OtherBCBSNC
NC890127RMedicaid
NC890127RMedicaid
NC10423OtherBCBSNC