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NPI Code Detail

MEDICARE: DAVID W PETERS MD PA

MEDICARE: DAVID W PETERS MD PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) Physician0428125KS

General Provider Information

NPI Number : 1902085251
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID W PETERS MD PA
Provider Business Mailing Address
First Line : 8800 STATE LINE RD
Second Line :
City : LEAWOOD
State : KS
Zip : 66206-1553
Country : US
Telephone Number : 913-383-9099
Fax Number :
Provider Business Practice Location Address
First Line : 8800 STATE LINE RD
Second Line :
City : LEAWOOD
State : KS
Zip : 66206-1553
Country : US
Telephone Number : 913-383-9099
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DAVID W PETERS
Credential : MD
Telephone Number : 913-383-9099
Provider Enumeration Date : 11/02/2007
Last Update Date : 04/05/2012

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