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Individual

DAVID PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 EAST 28TH STREET, MINNEAPOLIS, MN 55407
(612) 863-3547
Mailing address
PO BOX 86, LOCK BOX 12-0910, MINNEAPOLIS, MN 55486-0910
(612) 863-3547

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
29403
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
274500300
MN
Enumeration date
10/02/2006
Last updated
07/08/2007
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