Individual
MATTHEW PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3669
(414) 649-3370
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
72946-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100212268
—
WI
Enumeration date
03/25/2017
Last updated
09/16/2024
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