NPI Profile for MARY K PEABODY in JOHNS CREEK, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant | |
Physician Assistant |
363A00000X | 97 | Physician Assistant |
| NPI # | 1609459577 |
|
| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 04/29/2021 | |
| Last updated | 12/12/2022 - About 3 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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MARY K PEABODY
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