# DR. ERIC J PETERSEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1184890543
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 43275 | TX | — |
| 207Q00000X | Family Medicine Physician | 7333423-1205 | UT | — |
| 207Q00000X | Family Medicine Physician | MD 60036832 | WA | — |
| 207Q00000X | Family Medicine Physician | N8336 | TX | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | ML 20009169 | WA | — |

## Other

- **Enumeration date:** 05/06/2008
- **Last updated:** 07/12/2016