Individual
NICHOLAS PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
36000 EUCLID AVE, WILLOUGHBY, OH 44094-4625
(440) 953-9600
Mailing address
7757 AUBURN RD STE 15, CONCORD TOWNSHIP, OH 44077-9604
(440) 350-0832
(440) 579-0191
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67.000388
OH
Other
Enumeration date
07/23/2019
Last updated
05/06/2021
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