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Individual

GERALD PETERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
2054 WATSON BLVD, WARNER ROBINS, GA 31093-3634
(478) 633-2097
(478) 633-7836
Mailing address
409 HERITAGE DR, WARNER ROBINS, GA 31093-6621
(478) 922-7954

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN122988
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
498794628B
GA
Enumeration date
08/07/2006
Last updated
12/17/2012
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