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Individual

DR. BRIAN WOODFORD PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1375 E 20TH AVE, DENVER, CO 80205-5422
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
DR.0058571
CO
207N00000X
Dermatology Physician
LP02769
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
028287
KAISER COMMERCIAL NUMBER
CO
Enumeration date
07/05/2012
Last updated
09/06/2022
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