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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467087148 NPPES
Other 1172149 NATIONAL COMM ON CERTIFICATION OF PHYSICIAN ASSISTANCES

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