Individual
TIMOTHY A PETERSON
Active
Individual
TIMOTHY A PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
7777
ND
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
7777
ND
2084P0800X
Psychiatry Physician
7777
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1456145
—
ND
05
—
1694259
—
AK
Enumeration date
09/30/2006
Last updated
04/13/2026
Update your record
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