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Contact Information

THOMAS P PELLER MD SC
714 W HAMILTON AVE
EAU CLAIRE, WI54701-6937
 Phone: 715-830-9990
 Fax: 715-830-9995
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for THOMAS P PELLER MD SC

NPI # 1215008875
LBN Legal business name THOMAS P PELLER MD SC
Authorized official THOMAS PELLER - (DIRECTOR PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/13/2006
Last updated 03/10/2009 - About 17 years ago
Identifiers
WI License # 34997
WI Medicaid 32016000
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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