Individual
DR. PAUL H PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1420 109TH AVE NE STE 100, BLAINE, MN 55449-3603
(763) 581-5880
(763) 581-5551
Mailing address
1420 109TH AVE NE STE 100, BLAINE, MN 55449-3603
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
912
MN
Other
Enumeration date
07/11/2011
Last updated
12/17/2014
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