Individual
MICHELE L PEITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
401 W GLYNN DR, PARKSTON, SD 57366-9605
(605) 928-3311
(605) 928-4417
Mailing address
625 N FOSTER ST, STE 108, MITCHELL, SD 57301-2971
(605) 928-3311
(605) 928-4417
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0367
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4994845
WELLMARK PARKSTON
SD
01
—
4994846
WELLMARK TRIPP
SD
01
—
4994847
WELLMARK LAKE ANDES
SD
05
—
5340070
—
SD
05
—
5340340
—
SD
05
—
6825764
—
SD
05
—
6825765
—
SD
01
—
9238106
DAKOTACARE
SD
Enumeration date
11/02/2005
Last updated
09/21/2018
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