Peters, Timothy D.

Peters, Timothy D. is an individual health care provider with primary practice located at 2235 Mercury Way , Santa Rosa CA 95407-5473. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Peters, Timothy D. can be contacted via phone (707) 239-4426.

Contact Information

Primary practice address
2235 Mercury Way Santa Rosa CA 95407-5473
Phone: (707) 239-4426
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 39646 Kentucky
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X C195627 California

Profile Details

NPI number 1881635076
LBN Legal business name Peters, Timothy D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Jun 24th, 2024 - about 5 months ago

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 1881635076 NPPES
Kentucky MEDICAID 64105463

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