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Individual

MICHAEL E PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1115 W 9TH ST, YANKTON, SD 57078-3310
(605) 668-8850
(605) 668-9448
Mailing address
1000 W 4TH ST, SUITE 12, YANKTON, SD 57078-3730
(605) 274-2178
(605) 668-4404

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
4826
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01030622
PREFERRED ONE
SD
01
1580614
ARAZ
SD
01
236639
MIDLANDS CHOICE
SD
01
4826
DAKOTACARE
SD
05
7200512
SD
Enumeration date
10/12/2006
Last updated
08/18/2010
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