Individual
ADAM B PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
3801 S. NATIONAL, SPRINGFIELD, MO 65807
(417) 269-6000
Mailing address
1000 E. PRIMROSE SUITE 520, SPRINGFIELD, MO 65807
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2012015563
MO
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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