Individual
DR. CHRISTIAN TYLER PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708
(757) 953-7550
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-7550
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
20085
SC
207L00000X
Anesthesiology Physician
Primary
E-11290
AR
Other
Enumeration date
03/14/2006
Last updated
06/11/2018
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