Individual
KIRK DARREL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-7000
(919) 350-8959
Mailing address
5220 GREENS DAIRY RD, RALEIGH, NC 27616-4612
(919) 781-1437
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101271480
VA
2085R0202X
Diagnostic Radiology Physician
Primary
2006-00627
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5911234
—
NC
Enumeration date
05/15/2007
Last updated
04/28/2023
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