| Robert Peterson, PA-C | |
|
707 Ash Street, Spooner, WI 54801 | |
| (715) 635-2151 | |
| Not Available |
| Full Name | Robert Peterson |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 707 Ash Street, Spooner, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033198957 | NPI | - | NPPES |
| 209L9PE | Other | MN | BCBS |
| 410849339 56001 G011 | Other | CHAMPUS | |
| NA2951011331 | Other | MN | PREFERRED ONE |
| 110533700 | Medicaid | MN | |
| 115317 | Other | MN | UCARE |
| 0117135 | Other | MN | MEDICA |
| HP20659 | Other | MN | HEALTH PARTNERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 9873 (Minnesota) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Peterson, PA-C 707 Ash Street, Spooner, WI 54801 Ph: (715) 635-2151 | Robert Peterson, PA-C 707 Ash Street, Spooner, WI 54801 Ph: (715) 635-2151 |
Mr. Ethan Edward Smith, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1180 Chandler Dr, Spooner, WI 54801 Phone: 715-635-2151 |