Individual
MELISSA PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38154
CO
207R00000X
Internal Medicine Physician
5156
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018901
KAISER COMMERCIAL NUMBER
CO
01
—
200048563
TAX ID
AK
05
—
31676774
—
CO
01
—
610518100
DEPARTMENT OF LABOR
AK
01
—
DC5515
MEDICARE RAILROAD
AK
05
—
MD3818
—
AK
Enumeration date
04/10/2006
Last updated
09/29/2021
Update your record
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