Provider Demographics
NPI:1952598054
Name:PEAK MEDICAL CORP
Entity Type:Organization
Organization Name:PEAK MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COMISSIONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:340-777-8520
Mailing Address - Street 1:PEAK MEDICAL CORP.
Mailing Address - Street 2:PARAGON MEDICAL BUILDING, SUITE 207
Mailing Address - City:ST. THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802
Mailing Address - Country:US
Mailing Address - Phone:340-777-8520
Mailing Address - Fax:340-779-7256
Practice Address - Street 1:PEAK MEDICAL CORP.
Practice Address - Street 2:PARAGON MEDICAL BUILDING, SUITE 207
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-777-8520
Practice Address - Fax:340-779-7256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI923305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI1184730517OtherNPI
VI1811008055OtherNPI