Healthcare Provider Details

I. General information

NPI: 1174987895
Provider Name (Legal Business Name): PETER CMOREJ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 PIERCE ST STE 402
SIOUX CITY IA
51104-3766
US

IV. Provider business mailing address

2730 PIERCE ST STE 402
SIOUX CITY IA
51104-3766
US

V. Phone/Fax

Practice location:
  • Phone: 712-234-8725
  • Fax: 712-234-8728
Mailing address:
  • Phone: 712-234-8725
  • Fax: 712-234-8728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMD-56645
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number44500
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number44500
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberE-16333
License Number StateAR
# 5
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD-56645
License Number StateIA
# 6
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberE-16333
License Number StateAR
# 7
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA172696
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA172696
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: