Individual
DR. RICHARD ERIC PETERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5555 E ARAPAHOE RD, CENTENNIAL, CO 80122-2312
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35258
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01352582
—
CO
01
—
029078
KAISER COMMERCIAL NUMBER
CO
01
—
35258
STATE LICENSE
CO
Enumeration date
06/02/2006
Last updated
04/27/2021
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