Individual
PETER T MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5250 COMPETITION DR STE 100, BETTENDORF, IA 52722-8837
(563) 322-0971
(563) 324-0615
Mailing address
5250 COMPETITION DR STE 100, BETTENDORF, IA 52722-8837
(563) 322-0971
(563) 324-0615
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002160
IA
363A00000X
Physician Assistant
085003115
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209395029
MEDICARE PTAN
IL
01
—
578210026
MEDICARE PTAN
IA
Enumeration date
10/23/2007
Last updated
03/05/2026
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