Provider Demographics
NPI:1134451388
Name:KAMPERSCHROER, PETER CORNELIUS (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:CORNELIUS
Last Name:KAMPERSCHROER
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:PO BOX 201
Mailing Address - Street 2:
Mailing Address - City:WISE RIVER
Mailing Address - State:MT
Mailing Address - Zip Code:59762-0201
Mailing Address - Country:US
Mailing Address - Phone:406-832-3334
Mailing Address - Fax:
Practice Address - Street 1:66031 MONTANA HWY 43
Practice Address - Street 2:
Practice Address - City:WISE RIVER
Practice Address - State:MT
Practice Address - Zip Code:59762-0201
Practice Address - Country:US
Practice Address - Phone:406-832-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7767207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine