Peterson, Robert Lester

Peterson, Robert Lester is an individual health care provider with primary practice located at 900 Riverside Dr Suite Iii, Waupaca WI 54981-1983. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Peterson, Robert Lester can be contacted via phone (715) 258-8898.

Contact Information

Primary practice address
900 Riverside Dr Suite Iii Waupaca WI 54981-1983
Fax: (715) 258-6980
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 19601 Wisconsin

Profile Details

NPI number 1720144876
LBN Legal business name Peterson, Robert Lester
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2006
Last updated Jul 8th, 2007 - about 19 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 1720144876 NPPES
Wisconsin Other 19601 LICENSE
Wisconsin MEDICAID 31229100 LICENSE

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