Jerome, Peter Stevan
Jerome, Peter Stevan is an individual health care provider with primary practice located at 700 E Marshall Ave , Longview TX 75601-5580. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Jerome, Peter Stevan can be contacted via phone (903) 315-1488.Contact Information
Primary practice address
700 E Marshall Ave
Longview TX 75601-5580
Phone: (903) 315-1488
Fax: (903) 315-1656
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 12731 | North Dakota |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 51376 | Minnesota |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 23793 | Wisconsin |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | M-12784 | Idaho |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | M-12784 | Idaho |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | P4321 | Texas |
Profile Details
| NPI number | 1396740668 |
|---|---|
| LBN Legal business name | Jerome, Peter Stevan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2005 |
| Last updated | Jan 11th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396740668 | NPPES |
| Minnesota | Other | P00849680 | RAILROAD MEDICARE |
| Minnesota | Other | P02137176 | RAILROAD MEDICARE |
| Minnesota | MEDICAID | 393948001 | RAILROAD MEDICARE |
| Minnesota | MEDICAID | ENROLLED | RAILROAD MEDICARE |
| Minnesota | MEDICAID | 31692500 | RAILROAD MEDICARE |
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