Provider Demographics
NPI:1740978154
Name:PETERS, JENNIFER (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 FIFTH ST. NE
Mailing Address - Street 2:SUMMA HEALTH FAMILY MEDICINE RESIDENCY
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203
Mailing Address - Country:US
Mailing Address - Phone:330-615-3205
Mailing Address - Fax:330-761-6469
Practice Address - Street 1:155 FIFTH ST. NE
Practice Address - Street 2:SUMMA HEALTH FAMILY MEDICINE RESIDENCY
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203
Practice Address - Country:US
Practice Address - Phone:330-615-3205
Practice Address - Fax:330-761-6469
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program