Provider Demographics
NPI:1487757035
Name:PETERS, BRANDON MOSELEY (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:MOSELEY
Last Name:PETERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S ROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-4755
Mailing Address - Country:US
Mailing Address - Phone:252-335-2355
Mailing Address - Fax:252-338-0505
Practice Address - Street 1:206 S ROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-4755
Practice Address - Country:US
Practice Address - Phone:252-335-2355
Practice Address - Fax:252-338-0505
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine