Individual
DR. BRIAN PETERS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5607
(928) 453-0150
Mailing address
1205 W REMUDA WAY, PAYSON, AZ 85541-5209
(480) 221-1275
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28026
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
495102
—
AZ
Enumeration date
05/31/2006
Last updated
07/08/2007
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