Individual
MR. BENDT P PETERSEN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6701 AIRPORT BLVD STE 100, MOBILE, AL 36608-6701
(251) 607-6117
(251) 219-0746
Mailing address
6701 AIRPORT BLVD, BUILDING D SUITE 100, MOBILE, AL 36608
(251) 607-6117
(251) 219-0746
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
00016728
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
249129
—
AL
01
—
512-30874
BCBS
AL
Enumeration date
04/27/2006
Last updated
08/04/2022
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