Individual
DR. MICHAEL W. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 S AUSTIN RD, EAGLE LAKE, TX 77434-3202
(979) 234-5571
Mailing address
735 N 5TH ST STE U, SILSBEE, TX 77656-3838
(409) 291-0004
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K0994
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029922416
—
TX
Enumeration date
09/28/2006
Last updated
11/15/2022
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