Peterson, Justin William

Peterson, Justin William is an sole proprietor health care provider with primary practice located at 2424 S 90Th St , West Allis WI 53227-2455. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Peterson, Justin William can be contacted via phone (414) 321-2255.

Contact Information

Primary practice address
2424 S 90Th St West Allis WI 53227-2455
Phone: (414) 321-2255
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 71467 Wisconsin
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 5101020737 Michigan

Profile Details

NPI number 1033558010
LBN Legal business name Peterson, Justin William
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2013
Last updated Nov 17th, 2023 - about 2 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 1033558010 NPPES
Wisconsin MEDICAID 100091524

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