Provider Demographics
NPI:1679505267
Name:GERMSCHEID, PETER HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:HENRY
Last Name:GERMSCHEID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:811 2ND ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3559
Mailing Address - Country:US
Mailing Address - Phone:320-631-7000
Mailing Address - Fax:320-632-0534
Practice Address - Street 1:811 2ND ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3559
Practice Address - Country:US
Practice Address - Phone:320-631-7000
Practice Address - Fax:320-632-0534
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33526207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN151028C736OtherUCARE MINNESOTA
MN207802300Medicaid
MN28616GEOtherBCBS OF MINNESOTA
0120062OtherMEDICA
216245OtherAMERICA'S PPO
NA9230454506OtherPREFERRED ONE
MNA013OtherTRICARE
HP10473OtherHEALTH PARTNERS
MN28616GEOtherBCBS OF MINNESOTA
MN151028C736OtherUCARE MINNESOTA
080056713Medicare ID - Type UnspecifiedRR MEDICARE