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Individual
DENNIS L PETERSON
Active
Individual
DENNIS L PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33856
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-25185
MEDICA
MN
01
—
080049494
RR MEDICARE
MN
01
—
114462
UCARE
MN
05
—
118202100
—
MN
01
—
2F977PE
BLUE CROSS BLUE SHIELD
MN
01
—
325101845
PRIMEWEST
MN
01
—
764610
ARAZ
MN
01
—
HP21681
HEALTH PARTNERS
MN
01
—
MR1081007925
PREFERRED ONE
MN
Enumeration date
07/18/2006
Last updated
09/10/2013
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