Basic Information
| Provider Information | |||||||||
| NPI: | 1649235599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PETERS | ||||||||
| FirstName: | WAYNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1805 SHEA CENTER DR STE 30 | ||||||||
| Address2: | |||||||||
| City: | HIGHLANDS RANCH | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801292251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033572559 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4700 E ILIFF AVE | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035848900 | ||||||||
| FaxNumber: | 7205249475 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 06/22/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 27127 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.