Individual
CHRISTOPHER G PESKE
Active
Individual
CHRISTOPHER G PESKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
592
WI
363AM0700X
Medical Physician Assistant
Primary
592
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001856578Y
HUMANA
—
05
—
42926600
—
WI
Enumeration date
05/17/2006
Last updated
03/17/2018
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