Individual
JANA MICHELLE PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
365 COURTHOUSE ROAD, PRINCETON, WV 24740
(304) 425-3922
(304) 487-0229
Mailing address
365 COURTHOUSE ROAD, PRINCETON, WV 24740
(304) 425-3922
(304) 487-0229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
WV963
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720753
MT STATE BCBS
WV
05
—
0041701001
—
WV
Enumeration date
02/15/2007
Last updated
02/19/2013
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