Individual
MARK STEVEN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD16135
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010509
—
OR
Enumeration date
11/20/2006
Last updated
10/07/2020
Update your record
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