Individual
DAVID KELLOGG PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
36 S BROOKS ST, WISCONSIN PATHOLOGISTS, SC, MADISON, WI 53715-1304
(608) 826-2663
Mailing address
PO BOX 44159, WPSC-SVA BILLING, MADISON, WI 53744-4159
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
39132-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
327-02900
—
WI
Enumeration date
01/31/2006
Last updated
07/08/2007
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