Peterson, Elizabeth Michael

Peterson, Elizabeth Michael is an individual health care provider with primary practice located at 109 Warren St Suite 4, Beaver Dam WI 53916-3082. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Peterson, Elizabeth Michael can be contacted via phone (920) 885-3305.

Contact Information

Primary practice address
109 Warren St Suite 4 Beaver Dam WI 53916-3082
Phone: (920) 885-3305
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 46524-020 Wisconsin

Profile Details

NPI number 1417958026
LBN Legal business name Peterson, Elizabeth Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2005
Last updated Apr 27th, 2010 - about 14 years 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 1417958026 NPPES
Wisconsin MEDICAID 34638800

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