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1104540392
MARK PETERS
COLUMBUS, GA
NPI
1104540392
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner Pediatrics
(Licence: FL APRN11020587)
Enumeration Date
2022-09-30
Last Update Date
2022-09-30
Business Address
MARK PETERS APRN
3031 WILLIAMS RD
COLUMBUS, GA 31909-5633
Phone number: 706-221-7139
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Mailing Address
MARK PETERS APRN
11414 BLUFFS RDG
SPOTSYLVANIA, VA 22551-8915
Phone number: 646-346-0834
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