Peters, Gavin Paul
Peters, Gavin Paul is an individual health care provider with primary practice located at 107 E Highland Dr , Oconto Falls WI 54154-1002. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Peters, Gavin Paul can be contacted via phone (920) 846-3092.Contact Information
Primary practice address
107 E Highland Dr
Oconto Falls WI 54154-1002
Phone: (920) 846-3092
Fax: (920) 846-8313
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X |
Profile Details
| NPI number | 1467087148 |
|---|---|
| LBN Legal business name | Peters, Gavin Paul |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 3rd, 2020 |
| Last updated | Sep 26th, 2022 - about 3 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 | 1467087148 | NPPES |
| Other | 1172149 | NATIONAL COMM ON CERTIFICATION OF PHYSICIAN ASSISTANCES |
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