David J. Peterson, D.O.

Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Tamc, HI

NPI 1205032075 · NPPES record last updated Jun 26, 2023

Key facts

NPI
1205032075
Entity type
Individual (NPI type 1)
Primary specialty
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
License
DOS-1263 (HI)
Practice address
1 Jarrett White Rd
Tripler Army Medical Center
Tamc, HI 96859-5001
Phone
(808) 433-5198
Fax
(808) 433-6127
NPI assigned
Jun 26, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DOS-1263HIMDAnatomic Pathology & Clinical Pathology Physician
12206002-1204UTMDAnatomic Pathology & Clinical Pathology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X DOS-1263 HI Yes
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 12206002-1204 UT

Addresses

Primary practice location

1 Jarrett White Rd
Tripler Army Medical Center
Tamc, HI 96859-5001

Mailing address

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Phone (808) 433-5198

Other providers in Tamc, HI

All providers in Tamc, HI · Anatomic Pathology & Clinical Pathology Physician in Hawaii

Sources for this page

Verify at the official NPI Registry.