Individual
DR. MICHAEL SCOTT PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5000
(804) 675-5908
Mailing address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5000
(804) 675-5908
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
7533
TX
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
0618002288
VA
152WS0006X
Sports Vision Optometrist
4901004024
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4309851
—
MI
Enumeration date
07/17/2006
Last updated
09/24/2020
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