Individual
DR. JEANINE A PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
26932 SOUTHWOOD LN, OLMSTED FALLS, OH 44138-1157
(440) 427-1170
Mailing address
PO BOX 40450, BAY VILLAGE, OH 44140-0450
(440) 871-4700
(440) 871-4702
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36-00-3081-P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2103191
—
OH
01
—
480027126
MEDICARE RAILROAD PIN
OH
Enumeration date
06/03/2006
Last updated
06/25/2010
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