Provider Demographics
NPI:1588773527
Name:WINTER, JAMES PETER (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PETER
Last Name:WINTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1624 E SELTICE WAY
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-7022
Mailing Address - Country:US
Mailing Address - Phone:208-626-2949
Mailing Address - Fax:323-395-5867
Practice Address - Street 1:1624 E SELTICE WAY
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7022
Practice Address - Country:US
Practice Address - Phone:208-626-2949
Practice Address - Fax:323-395-5867
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-5391207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1588773527Medicaid
WA2011262Medicaid