Mary T Carr Peterson in West Des Moines - Medical

Mary T Carr Peterson - NPI 1164496212

Mary T Carr Peterson is a Medical in West Des Moines, Iowa. Mary T Carr Peterson practices all healthcare services and medical treatments related to Medical. 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 Medical
Taxonomy 363Am0700X
Licence No 1597
Definition:
A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment.

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 --

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FAQs about Mary T Carr Peterson

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 Medical, and the corresponding taxonomy code is 363Am0700X.

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.

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