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Individual
DR. DUSTIN J PETERSEN
Active
Individual
DR. DUSTIN J PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01073898A
IN
208600000X
Surgery Physician
26510
WV
2086S0102X
Surgical Critical Care Physician
Primary
01073898A
IN
2086S0102X
Surgical Critical Care Physician
26510
WV
2086S0127X
Trauma Surgery Physician
01073898A
IN
2086S0127X
Trauma Surgery Physician
26510
WV
Other
Enumeration date
07/10/2009
Last updated
10/10/2022
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