Doctor Name: | DR. PETER DEMEREST VANHOUTEN |
NPI Number: | 1841411758 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G43114 |
Business Practice Address: | 15301 Tyler Foote Rd. Nevada City, CA - 959599318 |
Business Phone Number: | 5302923478 |
Business Fax Number: | 5302924296 |
Mailing Address: | 14618 Tyler Foote Rd. #111, NEVADA CITY |
State: | CA |
Postal Code: | 959599318 |
Phone Number: | 5304787763 |
Fax Number: | 5302924296 |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G43114 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |