Provider Demographics
NPI:1285798074
Name:PEGG, WILLIAM JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:PEGG
Suffix:
Gender:M
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:PO BOX 2460
Mailing Address - Street 2:
Mailing Address - City:TEATICKET
Mailing Address - State:MA
Mailing Address - Zip Code:02536-2460
Mailing Address - Country:US
Mailing Address - Phone:508-548-3699
Mailing Address - Fax:508-548-6036
Practice Address - Street 1:26 GLEASON ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5223
Practice Address - Country:US
Practice Address - Phone:508-771-4850
Practice Address - Fax:508-771-3658
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59534207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9725890Medicaid
MAJ07620OtherBLUE SHIELD
MAJ07620OtherBLUE SHIELD
MA9725890Medicaid