Individual
SCOTT WILLIAM PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0290
(352) 265-0279
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 265-0290
(352) 265-0279
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
21748
LA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME80915
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1698954
—
LA
05
—
273967400
—
FL
Enumeration date
06/20/2005
Last updated
03/26/2008
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