Individual
PETER ROTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
275433
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43361800
—
WI
01
—
P00163391
MEDICARE RAILROAD
WI
Enumeration date
08/16/2006
Last updated
04/15/2025
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