Douglas B Peterson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21307 Issued in WI

Practice address

1512 W 4TH St
Marshfield, WI 54449-2509

Phone

(715) 387-4888

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1437267440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W 4TH ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544492509",
            "telephone_number": "715-387-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 W 4TH ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544492509",
            "telephone_number": "715-387-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DOUGLAS",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "21307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30136200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria C. Peters, CRNA
• Amy Lynn Peterson, OTR
• Andrea T Peterson, DO
• Coren Anne Peterson, O.T.R.
• Dennis Peterson, PAC
• Jamie Lynn Peterson, MD
• Katie L Peterson
• Robert James Peterson, OTR
• Scott A Peterson, DO
• Gauri Pethe, MD

• Internal Medicine Physician in Marshfield, WI
• Providers in Marshfield, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.