Individual
DR. THOMAS C PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
883 BLAKELY RD, COLCHESTER, VT 05446-4417
(802) 847-2055
Mailing address
91 PINE MEADOW DR, COLCHESTER, VT 05446-9615
(802) 343-5660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0420007198
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005970
—
VT
05
—
01135226
—
NY
Enumeration date
07/26/2006
Last updated
07/08/2007
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