Provider Demographics
NPI:1548531098
Name:HAUSS, PETER WALTER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:WALTER
Last Name:HAUSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 N DUPONT HWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-7540
Mailing Address - Country:US
Mailing Address - Phone:302-730-5280
Mailing Address - Fax:302-730-5285
Practice Address - Street 1:261 N DUPONT HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-7540
Practice Address - Country:US
Practice Address - Phone:302-730-5280
Practice Address - Fax:302-730-5285
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-14
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEAI-0002445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist