Individual
DR. DEBORAH J. PETERSEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 DELAFIELD ST, SUITE 115, WAUKESHA, WI 53188-3417
(262) 542-2536
(262) 542-2791
Mailing address
1111 DELAFIELD ST, SUITE 115, WAUKESHA, WI 53188-3417
(262) 542-2536
(262) 542-2791
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
31076
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23059300
—
WI
Enumeration date
02/20/2006
Last updated
07/08/2007
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