Individual
DR. ANDREW CLAIR PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1050 SW 3RD AVE, #3200, ONTARIO, OR 97914-2193
(541) 881-7373
(541) 881-7186
Mailing address
1050 SW 3RD AVE, #3200, ONTARIO, OR 97914-2193
(541) 881-7373
(541) 881-7186
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M6155
ID
207R00000X
Internal Medicine Physician
Primary
MDO9438
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003390300
—
ID
05
—
153049
—
OR
Enumeration date
04/13/2006
Last updated
02/04/2009
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