Provider Demographics
NPI:1871342444
Name:PETERS, BETHLEHEM (MD)
Entity type:Individual
Prefix:DR
First Name:BETHLEHEM
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 ROCKETCRESS DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2570
Mailing Address - Country:US
Mailing Address - Phone:336-307-6443
Mailing Address - Fax:
Practice Address - Street 1:3020 OLD CLINIC BUILDING CB 7570
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-4220
Practice Address - Country:US
Practice Address - Phone:919-966-4150
Practice Address - Fax:919-966-4150
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPETE-68VGEY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program