Individual
RANDALL PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1454 N COUNTY ROAD 2050, CARTHAGE, IL 62321-3551
(217) 357-8500
Mailing address
1454 N COUNTY ROAD 2050, PO BOX 160, CARTHAGE, IL 62321-3551
(217) 357-8500
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
47297
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34596200
—
WI
Enumeration date
06/23/2006
Last updated
06/12/2013
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