Provider Demographics
NPI:1871913988
Name:TOOLE-ROLLINS, PEGGY ANN (MD)
Entity type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:ANN
Last Name:TOOLE-ROLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:PEGGY
Other - Middle Name:ANN
Other - Last Name:TOOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3020 14TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6865
Mailing Address - Country:US
Mailing Address - Phone:202-469-4699
Mailing Address - Fax:
Practice Address - Street 1:3020 14TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-6865
Practice Address - Country:US
Practice Address - Phone:202-469-4699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140402208000000X
390200000X
TN056283208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ30444Medicaid