Individual
MITCHELL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MSC11 6025 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-3134
(505) 272-5062
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD2025-0249
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/22/2021
Last updated
11/20/2025
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