Individual
LUKE NUZUM PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
61805
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/21/2009
Last updated
09/19/2014
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