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Individual
DR. MARGIE H PETERSON
Active
Individual
DR. MARGIE H PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25502
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1016661
PREFERRED ONE
—
01
—
160056073
PALMETTO GBA RR MEDICARE
—
05
—
30701000
—
WI
01
—
46Q71PE
BCBS MN
—
Enumeration date
06/16/2005
Last updated
01/04/2010
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