Peterson, Wylan Cornelius
Peterson, Wylan Cornelius is an individual health care provider with primary practice located at 3551 Roger Brooke Dr Att'N Ms. Shawana Judge, Fort Sam Houston TX 78234-4504. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgical Critical Care is his primary health care specialty. Peterson, Wylan Cornelius can be contacted via phone (210) 916-1064.Contact Information
Primary practice address
3551 Roger Brooke Dr Att'N Ms. Shawana Judge
Fort Sam Houston TX 78234-4504
Phone: (210) 916-1064
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | Q0151 | Texas |
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 35-08-5446 | Ohio |
Allopathic & Osteopathic Physicians / Surgery | 208600000X | Q0151 | Texas |
Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | Q0151 | Texas |
Profile Details
NPI number | 1659395523 |
---|---|
LBN Legal business name | Peterson, Wylan Cornelius |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 26th, 2006 |
Last updated | Jun 18th, 2024 - about 5 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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