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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417958026 | NPPES |
| Wisconsin | MEDICAID | 34638800 |
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