Organization
CHARLES S PETERSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES S PETERSON MD (OWNER PRESIDENT)
(480) 558-3744
Entity
Organization
Contact information
Practice address
5111 N SCOTTSDALE RD, SUITE 101, SCOTTSDALE, AZ 85250-7075
(480) 558-3744
(480) 558-3801
Mailing address
PO BOX 2507, MESA, AZ 85214-2507
(480) 558-3744
(480) 558-3801
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
28027
AZ
Other
Enumeration date
06/18/2007
Last updated
12/04/2008
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