Mary T Carr Peterson in West Des Moines - Physician Assistant
Mary T Carr Peterson - NPI 1164496212
Mary T Carr Peterson is a Physician Assistant in West Des Moines, Iowa. Mary T Carr Peterson practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Mary T Carr Peterson is 1164496212. The last update date is 2022-09-08.
Mary T Carr Peterson's current location address is 7147 Vista Dr Ste 150, West Des Moines, Iowa. You can contact this provider via phone number 5158759925 and fax number 5158759923. The mailing address for Mary T Carr Peterson is 7147 Vista Dr Ste 150, West Des Moines, Iowa. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary T Carr Peterson |
|---|---|
| Address | 7147 Vista Dr Ste 150, West Des Moines, Iowa |
| Phone Number | 5158759925 |
| Fax Number | 5158759923 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1164496212 |
|---|---|
| Provider Enumeration Date | 2006-02-15 |
| Last Updated Date | 2022-09-08 |
Provider Mailing Address Detail
| Address | 7147 Vista Dr Ste 150 |
|---|---|
| City | West Des Moines |
| State | Iowa (IA) |
| Post Code | 502669317 |
| Phone Number | 5158759925 |
| Fax Number | 5158759923 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 1597 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 37903 | WELLMARK | ||
| 37904 | WELLMARK | ||
| 634600 | IA | -- | |
| 37905 | WELLMARK | ||
| 3117994 | IA | -- | |
| 37902 | WELLMARK | ||
| 1117994 | IA | -- | |
| 2117994 | IA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Mary T Carr Peterson by the Centers for Medicare & Medicaid Services (CMS)?
The Mary T Carr Peterson has been assigned the NPI (National Provider Identifier) 1164496212. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Mary T Carr Peterson located?
The Mary T Carr Peterson is located at 7147 Vista Dr Ste 150, West Des Moines, IA 502669317.
What is the Mary T Carr Peterson's specialty and taxonomy code?
The Mary T Carr Peterson's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1164496212 to Mary T Carr Peterson?
The Mary T Carr Peterson received its 1164496212 assignment from the Centers for Medicare & Medicaid Services on 2006-02-15.
When was the information pertaining to Mary T Carr Peterson most recently updated or revised?
The details related to Mary T Carr Peterson, including its address, specialty, and other relevant information, were last updated or revised on 2022-09-08.