Individual
DR. MARY T PETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
SPRINGFIELD RADIOLOGISTS ST JOHNS HOSPITAL, 800 E. CARPENTER STREET, SPRINGFIELD, IL 62769-0001
(217) 544-6464
Mailing address
SPRINGFIELD RADIOLOGISTS ST JOHNS HOSPITAL, 800 E. CARPENTER STREET, SPRINGFIELD, IL 62769-0001
(217) 544-6464
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-118257
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118257
—
IL
Enumeration date
01/16/2008
Last updated
09/16/2009
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