Provider Demographics
NPI:1114937562
Name:PETERS, CONSTANTINE G (DO)
Entity type:Individual
Prefix:DR
First Name:CONSTANTINE
Middle Name:G
Last Name:PETERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2338 IMMOKALEE RD # 186
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1445
Mailing Address - Country:US
Mailing Address - Phone:239-330-2933
Mailing Address - Fax:239-343-5348
Practice Address - Street 1:2338 IMMOKALEE RD # 186
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1445
Practice Address - Country:US
Practice Address - Phone:239-330-2933
Practice Address - Fax:239-343-5348
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036107020207R00000X, 208M00000X
FLOS17162208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110688200Medicaid
IL036107020Medicaid