Individual
PEGGY S PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1133 COLLEGE AVE, MANHATTAN, KS 66502-2770
(785) 539-5363
(785) 539-5862
Mailing address
1133 COLLEGE AVE, MANHATTAN, KS 66502-2770
(785) 539-5363
(785) 539-5862
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0518987
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000162020A
—
KS
01
—
220020955
RR MEDICARE
KS
Enumeration date
08/03/2006
Last updated
03/06/2012
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