Organization
J MICHAEL PETERSEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J MICHAEL PETERSEN MD (PRESIDENT)
(304) 233-2455
Entity
Organization
Contact information
Practice address
2000 EOFF ST, WHEELING, WV 26003-3823
(304) 233-2455
(304) 233-6073
Mailing address
109 MOUNT WOOD RD, WHEELING, WV 26003-2632
(304) 233-2455
(304) 233-6073
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
13832
WV
Other
Enumeration date
07/28/2017
Last updated
08/09/2017
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