Individual
PETER ROTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-2249
(920) 320-3529
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2249
(920) 320-3529
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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