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General NPI Number Information
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NPI Number | 1689341182
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Entity Type | Individual
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Provider Name | WILLIAM DAVID PETERS DNP, CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 1364 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30322-0004
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Country | US
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Telephone | 404-778-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 CAMERON GLEN DR
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City | MARIETTA
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State | GA
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Zip | 30062-3046
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Country | US
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Telephone | 917-821-6859
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN250386
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License Number State | GA
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