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Individual

LYNN JEFFREY KAY PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
35062198
OH
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
DR.0055021
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000009203
BCBS ANTHEM
OH
05
0932923
OH
Enumeration date
01/09/2007
Last updated
06/23/2015
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