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Individual

DR. ROBERT J PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
5050 CASCADE RD SE, GRAND RAPIDS, MI 49546-3725
(616) 957-0866
(616) 957-4102
Mailing address
5050 CASCADE RD SE, GRAND RAPIDS, MI 49546-3725
(616) 957-0866
(616) 957-4102

Taxonomy

Speciality
Code
Description
License number
State
152WP0200X
Pediatric Optometrist
Primary
003979
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13857
PRIORITY HEALTH HMO
MI
01
4362760
CHILDREN SPECIAL HEALTH
MI
05
4362760
MI
01
900D166360
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/11/2006
Last updated
03/01/2013
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