Individual
DR. RICHARD EDWARD PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 UPPER CHESAPEAKE DR, BEL AIR, MD 21014-4324
(410) 420-7630
Mailing address
3 COOPERSTOWN CT, PHOENIX, MD 21131-1328
(410) 472-3399
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0059072
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154631701
—
MD
Enumeration date
06/14/2006
Last updated
08/24/2010
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