Individual
PETER R DEHAAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3100 SUPERIOR AVE, SHEBOYGAN, WI 53081-1948
(920) 459-8300
Mailing address
225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4257
(262) 787-4040
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
58242
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/21/2011
Last updated
12/17/2021
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