Individual
DOUGLAS B PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1512 W 4TH ST, MARSHFIELD, WI 54449-2509
(715) 387-4888
Mailing address
1512 W 4TH ST, MARSHFIELD, WI 54449-2509
(715) 387-4888
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21307
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30136200
—
WI
Enumeration date
08/29/2006
Last updated
01/07/2013
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