Individual
RONALD D. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
(219) 836-1600
Mailing address
744 W MICHIGAN AVE, JACKSON, MI 49201-1909
(800) 242-1131
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
02002148A
IN
Other
Enumeration date
05/10/2006
Last updated
01/27/2010
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