Provider Demographics
NPI:1457314106
Name:PEET, FREDERICK JOSEPH JR (DPM)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:JOSEPH
Last Name:PEET
Suffix:JR
Gender:M
Credentials:DPM
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Mailing Address - Street 1:1201 JEFFERSON ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-4451
Mailing Address - Country:US
Mailing Address - Phone:636-239-0202
Mailing Address - Fax:636-239-0217
Practice Address - Street 1:1201 JEFFERSON ST
Practice Address - Street 2:SUITE 120
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-4454
Practice Address - Country:US
Practice Address - Phone:636-239-0202
Practice Address - Fax:636-239-0217
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2023-06-27
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Provider Licenses
StateLicense IDTaxonomies
MO000548213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4670200OtherAETNA
MO9774OtherBCBS OF MISSOURI
MO18509OtherHEALTHCARE USA
MO431711811001OtherTRICARE
MO2700040OtherUNITED HEALTH CARE
MO107216OtherHEALTHLINK
MO107216OtherHEALTHLINK