Individual
PETER MATEUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/07/2023
Last updated
01/18/2024
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