Michael Theodore Peterson (NPI# 1194768606, PAC ID# 8022044585) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1194768606 |
| PAC ID by PECOS | 8022044585 |
| Professional Enrollment ID | I20050715000446 |
| Full Name | Michael Theodore Peterson |
| Organization Legal Name | WAYNE MEMORIAL COMMUNITY HEALTH CENTERS |
| Address |
750 Route 739 Lords Valley PA 18428-6058 |
| Phone Number | 5707757100 |
| Gender | M |
| Credential | DO |
| Medical School | KIRKSVILLE COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1989 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 3072598937 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390125 | WAYNE MEMORIAL HOSPITAL |
| 390001 | GEISINGER-COMMUNITY MEDICAL CENTER |
| 390270 | GEISINGER WYOMING VALLEY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 750 Route 739, Lords Valley, PA 18428-6058 | 5707757100 | WAYNE MEMORIAL COMMUNITY HEALTH CENTERS |
| Organization Legal Name | WAYNE MEMORIAL COMMUNITY HEALTH CENTERS |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Murphy | General Surgery | Wayne Memorial Community Health Centers | 600 Maple Ave, Honesdale, PA 18431-1459 |
| Samuel Ganz | Internal Medicine | Wayne Memorial Community Health Centers | 44 N Scott St, Suite 2, Carbondale, PA 18407-2059 |
| Joanne Pellicane | Obstetrics/gynecology | Wayne Memorial Community Health Centers | 750 Route 739, Lords Valley, PA 18428-6058 |
| Richard Hacker | Emergency Medicine | Wayne Memorial Community Health Centers | 412 Como Rd, Lake Como, PA 18437-1020 |
| Joseph C Seprosky Jr. | Family Medicine | Wayne Memorial Community Health Centers | 1839 Fair Ave, Honesdale, PA 18431-2121 |
| Thomas Obrien | Obstetrics/gynecology | Wayne Memorial Community Health Centers | 110 Park St, Honesdale, PA 18431-2023 |
| Paula Bennett | Family Medicine | Wayne Memorial Community Health Centers | 600 Maple Ave, Honesdale, PA 18431-1459 |
| Charles D Aronica | Internal Medicine | Wayne Memorial Community Health Centers | 600 Maple Ave, Honesdale, PA 18431-1459 |
| William Russell Dewar Iii | Internal Medicine | Wayne Memorial Community Health Centers | 1839 Fair Ave, Honesdale, PA 18431-2121 |
| James G Cruse | Family Medicine | Wayne Memorial Community Health Centers | 750 Route 739, Lords Valley, PA 18428-6058 |
| Street Address |
750 ROUTE 739 |
| City | LORDS VALLEY |
| State | PA |
| Zip | 18428-6058 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joanne Pellicane | Obstetrics/gynecology | Wayne Memorial Community Health Centers | 750 Route 739, Lords Valley, PA 18428-6058 |
| James G Cruse | Family Medicine | Wayne Memorial Community Health Centers | 750 Route 739, Lords Valley, PA 18428-6058 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ethan A Singer | Nurse Practitioner | 2489 Us 6 Greshams Lndg, Suite 7, Hawley, PA 18428 | |
| Susan L Mowatt | Family Practice | The Singer Group, LLC | 2489 Us 6 Greshams Lndg, Suite 7, Hawley, PA 18428 |
| Jennifer Brown | Physical Therapy | Comprehensive Physical Therapy Inc | 103 Spruce St, Suite 101, Hawley, PA 18428-1149 |
| Susanna Daniels | Occupational Therapy | Comprehensive Physical Therapy Inc | 103 Spruce St, Suite 101, Hawley, PA 18428-1149 |
| Christine Marie Chesna | Physical Therapy | Comprehensive Physical Therapy Inc | 103 Spruce St, Suite 101, Hawley, PA 18428-1149 |
| Valerie A Bell | Nurse Practitioner | Lake Region Urgent Care, PC | 103 Spruce St, Suite 201, Hawley, PA 18428-1149 |
| Roman W Matlaga | Internal Medicine | Lake Region Urgent Care, PC | 103 Spruce St, Suite 201, Hawley, PA 18428-1149 |
| Breanne M Phillips | Physician Assistant | Lake Region Urgent Care, PC | 103 Spruce St, Suite 201, Hawley, PA 18428-1149 |
| Margaret Mary Lutz | Psychologist, Clinical | 8 Silk Mill Dr, Suite 223, Hawley, PA 18428-1413 | |
| Elizabeth Ciaravino | Psychologist, Clinical | 8 Silk Mill Dr, Suite 223, Hawley, PA 18428-1413 | |
| Find all physicians in zip 18428 | |||
| City | LORDS VALLEY |
| Zip Code | 18428 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | LORDS VALLEY + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Michael Theodore Peterson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.