Individual
KEVIN P PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 MARYLAND AVE E, UMPHYSICIANS PHALEN VILLAGE CLINIC, MINNEAPOLIS, MN 55106
(651) 772-3461
(651) 772-5477
Mailing address
720 WASHINGTON AVE SE, STE 200, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55414
(612) 884-0649
(612) 676-8992
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27012
MN
Other
Enumeration date
04/24/2006
Last updated
02/07/2013
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