| Peterson Neurology Pc | |
|
1140 Varnum St Ne Suite #101 Washington DC 20017-2151 | |
| (202) 526-2509 | |
| (202) 529-7215 |
| Full Name | Peterson Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1140 Varnum St Ne, Washington, District Of Columbia |
| Authorized Official Name and Position | William Peterson (PRESIDENT/OWNER) |
| Authorized Official Contact | 2025262509 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peterson Neurology Pc 1140 Varnum St Ne Suite #101 Washington DC 20017-2151 Ph: (202) 526-2509 | Peterson Neurology Pc 1140 Varnum St Ne Suite #101 Washington DC 20017-2151 Ph: (202) 526-2509 |
| NPI Number | 1831286335 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 05/22/2008 |
| Medicare PECOS PAC ID | 1951366889 |
|---|---|
| Medicare Enrollment ID | O20041119000834 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831286335 | NPI | - | NPPES |
| 232301000 | Medicaid | MD | |
| 011019400 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | MD12471 (District Of Columbia) | Primary |
| Provider Name | William Peterson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144419227 PECOS PAC ID: 8123083060 Enrollment ID: I20041122000041 |
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