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Individual
SCOTT PETERSON
Active
Individual
SCOTT PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7864
SD
Other
Enumeration date
08/06/2007
Last updated
09/02/2011
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