| Doctor Name: | DR. PETER F MCILVEEN |
| NPI Number: | 1124192737 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 2003-00501 |
| Business Practice Address: | 942 Johnson Ridge Rd Elkin, NC - 286212212 |
| Business Phone Number: | 3365263500 |
| Business Fax Number: | 3365263508 |
| Mailing Address: | 942 Johnson Ridge Rd, ELKIN |
| State: | NC |
| Postal Code: | 286212212 |
| Phone Number: | 3365263500 |
| Fax Number: | 3365263508 |
| NPI Enumeration Date: | 11/17/2006 |
| NPI Last Update Date: | 12/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VX0000X |
| License Number: | 2003-00501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Obstetrics |
| Taxonomy Definition: | |