Peterson, Stacy

Peterson, Stacy is an individual health care provider with primary practice located at 9000 W Wisconsin Ave , Milwaukee WI 53226-4874. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is her primary health care specialty. Peterson, Stacy can be contacted via phone (414) 266-3560.

Contact Information

Primary practice address
9000 W Wisconsin Ave Milwaukee WI 53226-4874
Phone: (414) 266-3560
Fax: (414) 266-6092
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 52973 Wisconsin
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 52973 Wisconsin

Profile Details

NPI number 1356515704
LBN Legal business name Peterson, Stacy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2008
Last updated Mar 13th, 2024 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356515704 NPPES
Wisconsin MEDICAID 1356515704

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