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Individual

PAUL ARNOLD PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3300 PROVIDENCE DR STE B-104, ANCHORAGE, AK 99508-4690
(607) 212-7997
(907) 212-8225
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(907) 212-7997
(907) 212-8225

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2641
AK
207RC0000X
Cardiovascular Disease Physician
2641
AK
207RI0011X
Interventional Cardiology Physician
2641
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060051650
RAILROAD MEDICARE
AK
05
1011916
AK
Enumeration date
07/13/2006
Last updated
11/24/2023
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