Individual
MRS. DIANE ELAINE BERGMAN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
940 CENTRAL PARK DRIVE, #209, STEAMBOAT SPRINGS, CO 80487
(970) 879-3738
(970) 870-6441
Mailing address
940 CENTRAL PARK DRIVE, #209, STEAMBOAT SPRINGS, CO 80487
(970) 879-3738
(970) 870-6441
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
30507
MN
207V00000X
Obstetrics & Gynecology Physician
Primary
46731
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46731
COLORADO STATE LICENSE
CO
Enumeration date
07/24/2006
Last updated
08/03/2011
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