Individual
PETER J QUANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-4711
Mailing address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-4711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
41183-020
WI
208M00000X
Hospitalist Physician
Primary
41183
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790708964
—
WI
01
—
P00147641
MEDICARE RAILROAD
WI
Enumeration date
07/26/2006
Last updated
07/29/2019
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