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Individual
DR. LON B. PETERSON
Active
Individual
DR. LON B. 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
30170
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-00067
MEDICA
MN
01
—
080108727
RAILROAD MEDICARE
MN
01
—
100055
UCARE MINNESOTA
MN
01
—
31362000
MEDICAID WI
MN
01
—
4K544PE
BLUE CROSS
MN
05
—
507782600
—
MN
01
—
66-02249
MEDICA URGENT CARE
MN
01
—
FP9703
AMERICAS PPO
MN
01
—
HP16949
HEALTH PARTNERS
MN
01
—
NA9141001149
PREFERRED ONE
MN
Enumeration date
03/17/2006
Last updated
11/10/2020
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