Provider Demographics
NPI:1831141043
Name:LAUREIJS, PETER J (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:LAUREIJS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 13TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-5067
Mailing Address - Country:US
Mailing Address - Phone:563-243-2511
Mailing Address - Fax:563-243-0817
Practice Address - Street 1:1021 11TH ST
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:IA
Practice Address - Zip Code:52742-1209
Practice Address - Country:US
Practice Address - Phone:563-659-9294
Practice Address - Fax:563-659-8104
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA31340207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
026711OtherHEALTH ALLIANCE
IA2144691Medicaid
IA0192OtherJOHN DEERE HEALTH
IA43791OtherWELLMARK BC/BS
27121OtherIOWA HEALTH SOLUTIONS
6446OtherMIDLANDS CHOICE
IL$$$$$$$$$Medicaid
IA2144691Medicaid
026711OtherHEALTH ALLIANCE
IA43791OtherWELLMARK BC/BS