Individual
ROBERT PETERIS VICKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 15TH ST, SUITE 210, GREELEY, CO 80631-4500
(970) 352-8216
(970) 352-5297
Mailing address
1800 15TH ST, SUITE 210, GREELEY, CO 80631-4500
(970) 352-8216
(970) 352-5297
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
47459
CO
2086S0127X
Trauma Surgery Physician
34611
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3858329
—
TN
Enumeration date
03/02/2006
Last updated
03/29/2010
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