Individual
BENJAMIN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8800 N TRYON ST, CHARLOTTE, NC 28262-3300
(704) 863-6000
Mailing address
7705 STONEHAVEN DR, WAXHAW, NC 28173-7334
(704) 488-5117
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
138152
NC
Other
Enumeration date
12/31/2021
Last updated
12/31/2021
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