Wallace, Richard Peterkin

Wallace, Richard Peterkin is an individual health care provider with primary practice located at 1001 S Fort Harrison Ave Suite 101, Clearwater FL 33756-3941. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Wallace, Richard Peterkin can be contacted via phone (727) 441-5044.

Contact Information

Primary practice address
1001 S Fort Harrison Ave Suite 101 Clearwater FL 33756-3941
Phone: (727) 441-5044
Fax: (727) 441-5008
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME85690 Florida
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X ME85690 Florida

Profile Details

NPI number 1275586448
LBN Legal business name Wallace, Richard Peterkin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Sep 27th, 2016 - about 9 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1275586448 NPPES
Florida Other P00294408 RAILROAD MEDICARE NUMBER
Florida MEDICAID 270183900 RAILROAD MEDICARE NUMBER

Popular Providers