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NPI Code Detail

MEDICARE: DR. ZACHARY B PETERS OD

MEDICARE: DR. ZACHARY B PETERS OD
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
1152W00000XOptometrist4901005532MI

General Provider Information

NPI Number : 1528633914
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ZACHARY B PETERS OD
Provider Business Mailing Address
First Line : 1002 N US HIGHWAY 27
Second Line :
City : SAINT JOHNS
State : MI
Zip : 48879-1129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1002 N US HIGHWAY 27
Second Line :
City : SAINT JOHNS
State : MI
Zip : 48879-1129
Country : US
Telephone Number : 989-224-3937
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2021
Last Update Date : 05/26/2021

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Directions to “ DR. ZACHARY B PETERS OD” Practice Location

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