Individual
TODD M PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1208 MERCHANT DR, KNOXVILLE, TN 37912-4707
(865) 688-2522
Mailing address
1225 E WEISGARBER RD, STE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35952
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0801955093
RR MEDICARE PIN
TN
05
—
3872129
—
TN
Enumeration date
04/29/2006
Last updated
05/09/2008
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