Healthcare Provider Details

I. General information

NPI: 1912186750
Provider Name (Legal Business Name): PETER SIGMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2007
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 RHODE ISLAND ST
STURGEON BAY WI
54235-1424
US

IV. Provider business mailing address

3732 ROCKY SHORE DR
STURGEON BAY WI
54235-9427
US

V. Phone/Fax

Practice location:
  • Phone: 920-746-8989
  • Fax: 920-746-8960
Mailing address:
  • Phone: 920-824-5193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number23243-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: