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Individual

DR. ERIK JORDAN PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5130 FAIRVIEW BLVD STE 100, WYOMING, MN 55092-8050
(651) 439-8807
(651) 439-0232
Mailing address
5130 FAIRVIEW BLVD STE 100, WYOMING, MN 55092-8050
(651) 439-8807
(651) 439-0232

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
57620
MN
207X00000X
Orthopaedic Surgery Physician
62173-20
WI

Other

Enumeration date
04/15/2009
Last updated
01/06/2021
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