Provider Demographics
NPI:1215901558
Name:PARRINO, PETER G (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:G
Last Name:PARRINO
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 1:4805 S MOORLAND RD
Mailing Address - Street 2:EMERGENCY MEDICINE
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-7401
Mailing Address - Country:US
Mailing Address - Phone:262-798-7200
Mailing Address - Fax:262-798-7201
Practice Address - Street 1:4805 S MOORLAND RD
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-7401
Practice Address - Country:US
Practice Address - Phone:262-798-7200
Practice Address - Fax:262-798-7201
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36795207PE0004X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1215901558Medicaid
WI32387900Medicaid
WI1215901558Medicaid
WI0003Medicare PIN
WI009002905Medicare PIN
WI665789Medicare UPIN
WI32387900Medicaid
WI002301473Medicare PIN