Individual
MATTHEW ALBERT PECKSKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1406 6TH AVENUE NORTH, ST CLOUD HOSPITAL, ST CLOUD, MN 56303-1900
(320) 251-2700
(320) 656-7115
Mailing address
1406 6TH AVENUE NORTH, ST CLOUD HOSPITAL, ST CLOUD, MN 56303-1900
(320) 251-2700
(320) 656-7115
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
11903
MN
363A00000X
Physician Assistant
Primary
2316
MN
Other
Enumeration date
09/08/2015
Last updated
04/12/2022
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