Individual
DR. GERALD E PETERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD25927
OR
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD25927
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00479104
MEDICARE RAILROAD
OR
05
—
269917
—
OR
Enumeration date
08/03/2006
Last updated
04/11/2016
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