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General NPI Number Information
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NPI Number | 1609294735
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Entity Type | Individual
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Provider Name | PETER EGGERT
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Gender | Male
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Dates
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Enumeration Date | 04/05/2014
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 1205 W AMERICAN DR
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City | NEENAH
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State | WI
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Zip | 54956-1405
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Country | US
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Telephone | 920-430-8113
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Fax | 920-430-8122
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Provider Business Mailing Address
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Address Line | 2223 LIME KILN RD STE 1
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City | GREEN BAY
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State | WI
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Zip | 54311-6238
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Country | US
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Telephone | 920-430-8113
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Fax | 920-430-8122
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 64502
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License Number State | WI
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