Peschke, Scott R

Peschke, Scott R is an individual health care provider with primary practice located at 2600 Kiley Way , Plymouth WI 53073-5020. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Peschke, Scott R can be contacted via phone (920) 449-7000.

Contact Information

Primary practice address
2600 Kiley Way Plymouth WI 53073-5020
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 25391 Wisconsin

Profile Details

NPI number 1659489789
LBN Legal business name Peschke, Scott R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2006
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659489789 NPPES
Wisconsin MEDICAID 30647600

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