Provider Demographics
NPI:1932546405
Name:PETERS, HERMAN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:CHARLES
Last Name:PETERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 980257
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0257
Mailing Address - Country:US
Mailing Address - Phone:804-828-7874
Mailing Address - Fax:804-827-1016
Practice Address - Street 1:2222 N NEVADA AVE STE 5017
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6865
Practice Address - Country:US
Practice Address - Phone:719-776-8040
Practice Address - Fax:719-776-6820
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01160314302086X0206X
CODR.00641192086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology