Individual
PETER RICHARD OBLIGATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 W IRONWOOD DR STE 170E, COEUR D ALENE, ID 83814-2666
(208) 292-0990
(208) 292-2950
Mailing address
3609 E LOOKOUT DR, COEUR D ALENE, ID 83815-7916
(208) 772-5860
(208) 762-3707
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G27958
CA
207P00000X
Emergency Medicine Physician
Primary
M6042
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G279580
MEDI CAL
—
05
—
00G279580
—
CA
01
—
010039635
RAILROAD MEDICARE
—
01
—
G27958
BLUE CROSS
—
Enumeration date
04/05/2006
Last updated
01/14/2011
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