Individual
KATHLEEN B PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5 CALDWELL RD, AUGUSTA, ME 04330-5739
(207) 623-1322
Mailing address
5 CALDWELL RD, AUGUSTA, ME 04330-5739
(207) 623-1322
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
012473
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005243
ANTHEM
ME
01
—
1041118
AETNA
ME
05
—
257240099
—
ME
01
—
6191075
CIGNA
ME
01
—
B86469
HARVARD PILGRIM
ME
Enumeration date
01/06/2006
Last updated
02/25/2014
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