Individual
ANNE E. PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1601 E BROADWAY, STE 240, COLUMBIA, MO 65201-8020
(573) 815-8145
(573) 815-3832
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(573) 815-8145
(573) 815-3832
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2006010643
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201431509
—
MO
01
—
210746
BCBS
MO
01
—
767347
HEALTHLINK
MO
01
—
CD6061
RAILROAD GROUP
MO
01
—
P00344374
RAILROAD MEDICARE
MO
Enumeration date
06/09/2006
Last updated
02/13/2017
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