Individual
STANLEY E PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
426 MCMILLEN ST, FORT ATKINSON, WI 53538-1996
(920) 563-7888
(920) 563-7741
Mailing address
426 MCMILLEN ST, FORT ATKINSON, WI 53538-1996
(920) 563-7888
(920) 563-7741
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
22907 020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30309100
—
WI
Enumeration date
10/10/2005
Last updated
07/08/2007
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