Individual
MARILYN J PEITSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 CENTRACARE CIRCLE, ST CLOUD, MN 56303
(320) 654-3630
(320) 654-3657
Mailing address
1900 CENTRACARE CIRCLE, ST CLOUD, MN 56303
(320) 654-3630
(320) 654-3657
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
26871
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037707400
MEDICAL ASSISTANCE MA
—
01
—
110144
UCARE
—
01
—
1202204
MEDICA HEALTH PLANS
—
01
—
2114138
FIRST HEALTH PLAN
—
01
—
254020
PREFERRED ONE
—
01
—
51A38PE
BLUE CROSS BLUE SHIELD
—
01
—
596183
ARAZ GROUP AMERICAS PPO
—
01
—
HP25503
HEALTH PARTNERS
—
Enumeration date
10/31/2005
Last updated
03/07/2023
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