# STEVEN L PETERSON PROFESSIONAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114121282
- **Authorized official:** STEVEN L PETERSON MD (OWNER)
- **Authorized official phone:** (970) 254-1686

## Contact information

- **Practice address:** 1120 WELLINGTON AVE, SUITE 208, GRAND JUNCTION, CO 81501-6129
- **Practice address phone:** (970) 254-1686
- **Practice address fax:** (970) 254-1687
- **Mailing address:** 2754 COMPASS DR, STE 300, GRAND JUNCTION, CO 81506-8714
- **Mailing address phone:** (970) 254-1686
- **Mailing address fax:** (970) 254-1687

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | 35550 | CO | Yes |

## Other

- **Enumeration date:** 06/13/2007
- **Last updated:** 01/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DG0363 | RAILROAD MEDICARE | — |