Peterson, Jay William

Peterson, Jay William is an individual health care provider with primary practice located at 2305 Genoa Business Park Dr Suite 170, Brighton MI 48114-7367. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Peterson, Jay William can be contacted via phone (810) 299-8550.

Contact Information

Primary practice address
2305 Genoa Business Park Dr Suite 170 Brighton MI 48114-7367
Phone: (810) 299-8550
Fax: (810) 844-0837
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X JP004176 Michigan

Profile Details

NPI number 1558320853
LBN Legal business name Peterson, Jay William
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Jun 7th, 2011 - about 13 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 1558320853 NPPES
Michigan Other 0D71023 BCBSM
Michigan Other JP004176 BCBSM

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