Individual
PETER DAHLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 TRINITY DR, PHILLIPS, WI 54555
(715) 339-2101
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23944
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30392000
—
WI
Enumeration date
09/30/2006
Last updated
07/08/2007
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