Individual
WILLIAM J PETERSILGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 AUBURN DR # 210, BEACHWOOD, OH 44122-4317
(216) 844-5595
(216) 844-5522
Mailing address
24701 EUCLID AVE, 3RD FLOOR BILLING SERVICES, EUCLID, OH 44117-1714
(216) 844-5595
(216) 844-5522
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35-057863
OH
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
BP1984740
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221152
UNISON
OH
01
—
000000503689
ANTHEM
OH
01
—
0655674
AETNA
OH
05
—
0929106
—
OH
01
—
363909
WELLCARE
OH
01
—
738084
BUCKEYE
OH
01
—
P00076234
RAILROAD MEDICARE
OH
01
—
P00358835
RAILROAD MEDICARE
OH
Enumeration date
07/28/2006
Last updated
01/12/2021
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