Individual
WILLIAM C PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7320
(757) 668-9735
Mailing address
PO BOX 79137, BALTIMORE, MD 21279-0137
(757) 668-7200
(757) 668-9691
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101036098
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017368930001
—
PA
05
—
005709733
—
VA
05
—
1000035696
—
DE
05
—
1840707000
—
WV
05
—
633236600
—
MD
05
—
8905209
—
NC
Enumeration date
06/07/2006
Last updated
12/18/2009
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