Individual
RICHARD J PELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1421 PREMIER DR, MANKATO CLINIC, MANKATO, MN 56001
(507) 625-1811
Mailing address
PO BOX 8674, 1230 E MAIN ST, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35968
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110346
MEDICA MN
—
01
—
080083832
RR MEDICARE
—
01
—
115901
UCARE MN
—
01
—
1666857
AMERICAS PPO MN
—
01
—
18A65PE
BCBS MN
—
01
—
41084933956001C107
CHAMPUS
—
05
—
789317500
—
MN
01
—
HP25859
HEALTH PARTNERS MN
—
01
—
NA2951023850
PREFERRED ONE MN
—
Enumeration date
01/10/2006
Last updated
07/15/2020
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