Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
RYAN C PETERSEN
Active
Individual
RYAN C PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD24586
OR
208M00000X
Hospitalist Physician
Primary
MD24586
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227352
—
OR
Enumeration date
09/27/2006
Last updated
04/03/2017
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