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Individual
TODD VICTOR PETERSON
Active
Individual
TODD VICTOR PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD065733L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001739250 0007
—
PA
05
—
0017392500005
—
PA
01
—
080135921
RAILROAD MEDICARE
PA
01
—
1007307260034
MEDICAID GROUP #
PA
01
—
120420420
DEPT OF LABOR
PA
01
—
122865
UNISON
PA
01
—
2117289
MAMSI
PA
01
—
2134441
AETNA HMO
PA
01
—
2160082
FIRST HEALTH
PA
01
—
25-1716306
HEALTHNET/TRICARE
PA
01
—
426611
HEALTH AMERICA
PA
01
—
50059950
CAPITAL BLUECROSS (EPIQ)
PA
01
—
50085311
CAPITAL BLUECROSS (WH)
PA
01
—
5957727
AETNA NON-HMO
PA
01
—
867633
MEDICARE GROUP #
PA
01
—
G920-0027/KDM4PO
CAREFIRST
PA
01
—
MD065733L
LICENSE
PA
01
—
PE085826
HIGHMARK BLUESHIELD
PA
Enumeration date
06/13/2005
Last updated
03/07/2023
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