Individual
EMILY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
705 S UNIVERSITY AVE STE 200, BEAVER DAM, WI 53916-3079
(920) 887-9272
(608) 833-6932
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
66142-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2014
Last updated
01/14/2021
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