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Individual

WILLIAM R PEGLOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
(952) 442-6535
Mailing address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
(952) 442-6535

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24363
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
24363
MEDICAL LICENSE
MN
Enumeration date
07/20/2005
Last updated
02/24/2010
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