Provider Demographics
NPI:1710411541
Name:DELEEUW, PETER MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:MICHAEL
Last Name:DELEEUW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1105 EAGLETREE LN SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6447
Mailing Address - Country:US
Mailing Address - Phone:256-261-2826
Mailing Address - Fax:256-539-4240
Practice Address - Street 1:1105 EAGLETREE LN SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6447
Practice Address - Country:US
Practice Address - Phone:256-261-2826
Practice Address - Fax:256-539-4240
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.3357207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology