Individual
JOHN DAVID PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6285
(864) 560-6063
Mailing address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6285
(864) 560-6063
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LL83119
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2020
Last updated
05/14/2020
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