Individual
DR. MCKIM C PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
195 UNION ST, MIDCOAST MEDICINE, PA, ROCKPORT, ME 04856-6107
(207) 236-2169
(207) 230-0413
Mailing address
PO BOX 1079, MIDCOAST MEDICINE, PA, ROCKPORT, ME 04856-1079
(207) 236-2169
(207) 230-0413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
013075
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130430000
—
ME
Enumeration date
08/23/2006
Last updated
03/24/2011
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