| Doctor Name: | PETER ALLEN FENN |
| NPI Number: | 1831140268 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 100867 |
| Business Practice Address: | 129 Lanier St. Buies Creek, NC - 275060565 |
| Business Phone Number: | 9108931559 |
| Business Fax Number: | 9108931559 |
| Mailing Address: | 101 Country Meadow Ln., COATS |
| State: | NC |
| Postal Code: | 275219556 |
| Phone Number: | 9108972354 |
| Fax Number: | |
| NPI Enumeration Date: | 05/12/2006 |
| NPI Last Update Date: | 02/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 100867 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |