Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | EP006039 | MI |
NPI | 1598898348 |
---|---|
Provider Name | Dr. Eric Kees Peet |
First Address | Saugatuck, MI 49453 |
Second Address | Saugatuck, MI 49453-9736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U45037 | (02) |