Peterson, Michael Andrew

Peterson, Michael Andrew is an individual health care provider with primary practice located at 1615 Maple Lane , Ashland WI 54806. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Peterson, Michael Andrew can be contacted via phone (715) 682-4563.

Contact Information

Primary practice address
1615 Maple Lane Ashland WI 54806
Phone: (715) 682-4563
Fax: (715) 685-5108
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 80086030 Wisconsin

Profile Details

NPI number 1023087046
LBN Legal business name Peterson, Michael Andrew
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jul 8th, 2007 - about 18 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 1023087046 NPPES
Wisconsin MEDICAID 44320400

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