Provider Demographics
NPI:1194944033
Name:PELOQUIN, DORTHE RAUHOLT (MD)
Entity type:Individual
Prefix:DR
First Name:DORTHE
Middle Name:RAUHOLT
Last Name:PELOQUIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4344 HARDY MCMANUS RD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5016
Mailing Address - Country:US
Mailing Address - Phone:706-863-2810
Mailing Address - Fax:706-863-3233
Practice Address - Street 1:4344 HARDY MCMANUS RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-5016
Practice Address - Country:US
Practice Address - Phone:706-863-2810
Practice Address - Fax:706-863-3233
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA026015207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine