Individual
DR. SHAWN M. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
25 S 9TH ST FL 1, PHILADELPHIA, PA 19107-4408
(215) 955-1200
(215) 923-6808
Mailing address
25 S 9TH ST FL 1, PHILADELPHIA, PA 19107-4408
(215) 955-1200
(215) 923-6808
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS018116
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103119238
—
PA
Enumeration date
05/21/2012
Last updated
12/19/2018
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