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Individual

STEVE ALAN PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5601 LOCH RAVEN BLVD, SMYTH BLDG, SUITE G-1, BALTIMORE, MD 21239-2945
(443) 444-4740
(443) 444-4752
Mailing address
5601 LOCH RAVEN BLVD, SMYTH BLDG, SUITE G-1, BALTIMORE, MD 21239-2945
(443) 444-4740
(443) 444-4752

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
D0065131
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
012124000
MD
Enumeration date
06/02/2006
Last updated
01/18/2017
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