Individual
DR. PETER BURNETT JOHANSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 FREEMAN DR, SAINT PETER, MN 56082-3504
(507) 931-7100
(507) 931-7220
Mailing address
100 FREEMAN DR, SAINT PETER, MN 56082-3504
(507) 931-7100
(507) 931-7220
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
21413
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32F28JO
BC/BS MPIN
MN
Enumeration date
01/06/2006
Last updated
07/08/2007
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