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NPI Code Detail

MEDICARE: CHRISTINA M PETERS D.O.

MEDICARE:   CHRISTINA M PETERS  D.O.
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
1207Q00000XFamily Medicine Physician34009788OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14293791OTHERMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235312158
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA M PETERS D.O.
Provider Business Mailing Address
First Line : 1 PARK CENTER DR STE 304
Second Line :
City : WADSWORTH
State : OH
Zip : 44281-9482
Country : US
Telephone Number : 330-336-3631
Fax Number : 330-336-3762
Provider Business Practice Location Address
First Line : 1 PARK CENTER DR STE 304
Second Line :
City : WADSWORTH
State : OH
Zip : 44281-9482
Country : US
Telephone Number : 330-336-3631
Fax Number : 330-336-3762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2007
Last Update Date : 08/15/2011

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Directions to “ CHRISTINA M PETERS D.O.” Practice Location

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