Individual
DR. BENJAMIN AMBROSE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-6922
(336) 716-5438
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2025-01204
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2022
Last updated
12/19/2025
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