Stacy L Peterson, M.D. Valid NPI

Individual provider · Plastic and Reconstructive Surgery Physician · Wichita, KS

NPI

1316030638

Type

Individual (Type 1)

Primary specialty

Plastic and Reconstructive Surgery Physician (Surgery)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

2086S0122X

License number

0419242 (KS)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-09-30

Last updated

2007-07-08