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Individual

IAN PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPH, DO

Contact information

Practice address
179 S PARKSIDE DR, COLORADO SPRINGS, CO 80910-3130
(719) 572-6100
Mailing address
100 E LEHIGH AVE, SUITE 105, PHILADELPHIA, PA 19125-1012
(215) 707-8483
(215) 707-0395

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
DR.0061752
CO
2084P0800X
Psychiatry Physician
OT015344
PA

Other

Enumeration date
06/28/2011
Last updated
08/02/2019
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