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Individual
DR. MICHAEL CHARLES PETERSEN
Active
Individual
DR. MICHAEL CHARLES PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2006027561
MO
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
Q2049
TX
Other
Enumeration date
09/12/2006
Last updated
09/04/2019
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