Individual
DR. GERALDINE ANNE PETERDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
MD00041937
WA
207ZP0101X
Anatomic Pathology Physician
Primary
MD00041937
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8331084
—
WA
01
—
AB 35581
MEDICARE WA
WA
Enumeration date
06/03/2006
Last updated
11/17/2014
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