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Organization
CAROL E. PETERSON, MD PLC
Active
Organization
CAROL E. PETERSON, MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER RYAN BOEREMA CPC (PATIENT ACCOUNTS MANAGER)
(231) 757-1260
Entity
Organization
Contact information
Practice address
6050 N US HIGHWAY 31, FREE SOIL, MI 49411-9157
(231) 757-1260
(231) 757-1261
Mailing address
6050 N US HIGHWAY 31, FREE SOIL, MI 49411-9157
(231) 757-1260
(231) 757-1261
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
4301050870
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0531035
BLUE CROSS BLUS SHIELD
MI
05
—
4831985
—
MI
Enumeration date
10/22/2007
Last updated
02/14/2008
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