Peterson, Lance William
Peterson, Lance William is an individual health care provider with primary practice located at 1 Childrens Pl Div Ped Rheumatology, Saint Louis MO 63110-1002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Rheumatology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Rheumatology is his primary health care specialty. Peterson, Lance William can be contacted via phone (314) 454-6124.Contact Information
Primary practice address
1 Childrens Pl Div Ped Rheumatology
Saint Louis MO 63110-1002
Phone: (314) 454-6124
Fax: (844) 616-1418
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Rheumatology | 2080P0216X | 2019042209 | Missouri |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2019042209 | Missouri |
Profile Details
| NPI number | 1528552510 |
|---|---|
| LBN Legal business name | Peterson, Lance William |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2018 |
| Last updated | Jul 2nd, 2024 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528552510 | NPPES |
| Missouri | MEDICAID | 200065295 |
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